CARCContractual Obligation
CARC 3: Copay Amount
A fixed dollar amount you owe for this visit or service as defined by your plan.
What this means for your claim
Your plan requires a flat copay for this type of service (e.g., $30 for a primary care visit). This is separate from your deductible.
What to do next
- 1
Cross-reference the copay amount with your plan's schedule of benefits for the specific service type.
- 2
If you were charged more than your plan's copay, contact the provider's billing office with your EOB.
- 3
Confirm the service was coded correctly — a preventive visit billed as a sick visit can trigger a copay that should be $0.
Have more codes on your EOB?
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