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CO-262 Code: Pharmaceutical Delivery Cost Adjustment

CO-262 is an adjustment for delivery cost, and its usage limits it to pharmaceuticals. The payer reduced or denied the amount billed for delivering a drug to the patient, such as home delivery by a specialty or retail pharmacy.

Code: CO-262 (CARC 262)
Status: Active In use since November 1, 2014; last modified July 1, 2017.
Code set: Claim Adjustment Reason Codes (CARC)
Group codes: CO (Contractual Obligation): The unpaid delivery cost is a provider or pharmacy write-off under the contract or payer policy and generally cannot be billed to the patient.
PR (Patient Responsibility): Used where the plan makes delivery an optional member-paid service, so the delivery charge is the patient's responsibility.
Official description: Adjustment for delivery cost. Usage: To be used for pharmaceuticals only.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What CO-262 means

CARC 262 is an adjustment for delivery cost, and the usage note says it is to be used for pharmaceuticals only. It belongs to a small family of pharmaceutical cost codes (262 through 266) that let a payer separate the drug’s ingredient cost from the extra costs around dispensing it.

Delivery is the hand-off of the medication to the patient’s home or care setting, often by courier or pharmacy staff. Some pharmacy contracts pay a delivery fee, some pay nothing extra, and some pay only in certain cases, such as for homebound patients or specialty drugs. When the payer adjusts the delivery portion, CARC 262 identifies it.

Distinguishing delivery from its siblings matters: CO-263 is for shipping, CO-264 is for postage, and CO-265 is for administrative cost. Payers may reimburse one and not another.

Common causes

Pharmacy agreement excludes delivery fees for this plan.
Delivery billed above the contract rate.
Delivery billed for a patient or drug that doesn’t qualify under the plan’s delivery rules.
Delivery included in the dispensing fee, so a separate charge is not payable.
Duplicate delivery charges when a refill and a new prescription went out together in one trip.

How to fix it

Check the pharmacy network agreement or payer manual for delivery reimbursement terms.
Confirm the patient and drug qualified, if delivery is only covered in specific situations.
If the contract pays delivery, request reprocessing or submit a corrected claim with the right amount and qualifier.
If it does not, post the adjustment and stop billing delivery to that payer.
If reported as PR, follow your disclosure practices before charging the patient.

How to prevent it

Maintain a payer-by-payer table of which dispensing-related costs are reimbursable.
Configure pharmacy software so delivery charges are sent only where covered.
Inform patients ahead of time when delivery is an out-of-pocket convenience.

Specialty notes

Specialty and home-infusion pharmacies are the main users. Physician offices generally will not see CO-262 unless they bill drug delivery charges.

Remark codes that may appear with CO-262

N381 (Alert: Consult our contractual agreement for restrictions/billing/payment information related to these charges.): Points to the pharmacy agreement terms on delivery fees.
N130 (Consult plan benefit documents/guidelines for information about restrictions for this service.): Points to plan documents on delivery benefits.

CO-263 (Adjustment for shipping cost.): Shipping cost for pharmaceuticals, typically carrier charges for mailed drugs.
CO-264 (Adjustment for postage cost.): Postage cost for pharmaceuticals.
CO-265 (Adjustment for administrative cost.): Administrative cost for pharmaceuticals.
CO-266 (Adjustment for compound preparation cost.): Compound preparation cost for pharmaceuticals.

CO-262 FAQ

What counts as delivery cost?

Charges for getting a dispensed drug to the patient, such as courier or pharmacy-staff home delivery. Payers differ on whether they treat delivery, shipping, and postage as separate items.

Can I bill the patient for delivery denied with CO-262?

Not under the CO group. If the plan treats delivery as optional and reports it as PR, you may be able to charge the patient according to your pharmacy agreement and any member disclosures.

Is CO-262 used on medical claims?

Its usage restricts it to pharmaceuticals, so it mostly appears on pharmacy claims and on medical claims for drugs where a delivery charge was billed.

Does CO-262 mean the drug was denied?

Not necessarily. It adjusts the delivery portion. The drug itself may be paid in full, so look at the other amounts on the line before treating it as a denial.

Important: read before using this information

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