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CO-P24 Denial Code: P&C Payment Adjusted per PPO

CO-P24 means a property and casualty payer adjusted payment based on a Preferred Provider Organization (PPO) arrangement. The carrier applied a PPO network discount it believes you agreed to, often through a network you joined or a rented network.

Quick facts

Code
CO-P24 (CARC P24)
Status
Active In use since November 1, 2017.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The usual group. The discount is contractual and generally can't be billed to the claimant.
Official description
Payment adjusted based on Preferred Provider Organization (PPO). Usage: If adjustment is at the Claim Level, the payer must send and the provider should refer to the 835 Class of Contract Code Identification Segment (Loop 2100 Other Claim Related Information REF). If adjustment is at the Line Level, the payer must send and the provider should refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment information REF) if the regulations apply. To be used for Property and Casualty only. Use only with Group Code CO.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-P24 means

CARC P24 says payment adjusted based on Preferred Provider Organization (PPO). X12 limits it to property and casualty claims.

Workers’ comp, auto, and liability carriers often contract with PPO networks, or rent access to them, to reduce medical costs. If you’ve signed a PPO agreement that covers P&C business, or a network you joined leases your contract to P&C carriers, the carrier can apply the contracted rate to your bill. It reports the discount as CO-P24.

The key question is whether a valid agreement actually exists. Network rental and “silent PPO” arrangements can extend discounts to carriers you’ve never dealt with directly.

Common causes

  • Direct PPO contract covering workers’ comp or auto services.
  • Rented network access, where your PPO leases its contracts to P&C carriers.
  • Bill review vendor matching your tax ID to a network contract.
  • Outdated or terminated contract still being applied.

How to handle it

  1. Identify the network and contract the carrier used; it should be named on the explanation of review or available on request.
  2. Check your agreements for P&C participation and rental provisions.
  3. Verify the rate against the contract and any state limits on PPO pricing.
  4. If valid, post the discount as a contractual adjustment. Don’t bill the claimant.
  5. If not valid, dispute it with the carrier or bill review company, citing the missing or terminated agreement.

How to prevent problems

  • Inventory all network agreements and note which cover P&C business.
  • Restrict rental access in contract negotiations where possible.
  • Terminate unused networks formally and keep confirmation.
  • Monitor P&C discounts. An ERA Analyzer can surface CO-P24 amounts by carrier and network.

Specialty notes

Practices with high workers’ comp and auto volume, such as orthopedics, PT, and occupational medicine, are most exposed to network rental discounts and should review their agreements regularly.

Remark codes that may appear with CO-P24

  • N381 (Alert: Consult our contractual agreement for restrictions/billing/payment information related to these charges.): Directs you to the contractual agreement that authorizes the discount.
  • N663 (Adjusted based on an agreed amount.): Adjusted based on an agreed amount.
  • CO-P25 (Payment adjusted based on Medical Provider Network (MPN).): Adjusted based on a Medical Provider Network, a workers' comp network type.
  • CO-P26 (Payment adjusted based on Voluntary Provider network (VPN).): Adjusted based on a Voluntary Provider Network.
  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): Standard fee schedule or contract reduction used in health claims.
  • CO-131 (Claim specific negotiated discount.): A claim-specific negotiated discount.

CO-P24 FAQ

Why would a P&C carrier apply a PPO discount?

Many workers' comp and auto carriers contract with PPO networks, or rent access to them, to reduce medical costs. If you're in one of those networks, your contracted rate may apply to P&C bills.

What if I never agreed to a P&C PPO discount?

Ask the carrier which network and contract it used. Rental network agreements sometimes allow access you didn't expect. If you have no valid agreement, dispute the discount.

Can a PPO discount go below the state fee schedule?

Some states allow PPO rates below the workers' comp fee schedule; others limit them. Check the state's rules.

Is CO-P24 used by health plans?

No. X12 limits it to property and casualty claims.

Is a PPO discount on a P&C bill a denial?

No. The bill was paid at the discounted rate. The only question is whether the discount was authorized by a valid agreement.

Does the PPO discount apply before or after the fee schedule?

It depends on the contract and state rules. Many carriers compare the fee schedule amount with the PPO rate and pay the lower one, where the state allows.