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CO-Y3 Denial Code (Deactivated): MPC/PIP Fee Schedule

CO-Y3 meant an auto insurer reduced payment to the jurisdiction's fee schedule for Medical Payments Coverage or Personal Injury Protection benefits. X12 deactivated it and its notes direct payers to code P23.

X12 deactivated CARCY3 on July 1, 2014. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Quick facts

Code
CO-Y3 (CARC Y3)
Status
Deactivated StoppedJuly 1, 2014 (in use since September 30, 2012).
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • CO (Contractual Obligation): The reduction to the fee schedule was a provider adjustment.
Official description
Medical Payments Coverage (MPC) or Personal Injury Protection (PIP) Benefits jurisdictional fee schedule adjustment. Note: 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 P&C Auto only.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CO-Y3 meant

CARC Y3 was the fee schedule code in the auto insurance Y-series. Where a state sets maximum fees for medical care paid under Medical Payments Coverage or Personal Injury Protection, the carrier reduced the bill to that amount and reported the difference with Y3. It is the auto counterpart of the workers’ compensation fee schedule code.

What replaced it

X12’s note says to use code P23. CO-P23 now reports MPC or PIP jurisdictional fee schedule adjustments. For reductions based on regulations or policies rather than a schedule, carriers use CO-P22. Liability coverage has its own fee schedule code, CO-P29.

If you still see CO-Y3

It will only be on older auto claims. Verify the allowed amount against the state’s schedule for the date of service and region. If the carrier applied the wrong schedule or year, request reprocessing with the correct figures. If it is correct, post the reduction as an adjustment.

  • CO-P23 (Medical Payments Coverage (MPC) or Personal Injury Protection (PIP)): Named replacement: MPC or PIP jurisdictional fee schedule adjustment.
  • CO-P22 (Payment adjusted based on the Medical Payments Coverage (MPC) and/or Personal Injury Protection (PIP)): Payment adjusted under MPC or PIP regulations or payment policies.
  • CO-P29 (Liability Benefits jurisdictional fee schedule adjustment.): Liability benefits jurisdictional fee schedule adjustment.

CO-Y3 FAQ

Do auto insurers use fee schedules?

In some states, yes. Certain states set fee schedules for medical care paid under PIP or similar auto benefits, often tied to other public fee schedules.

Is a CO-Y3 reduction billable to the patient?

Often not, where state law limits charges to the fee schedule for PIP-covered care. Check the state's rules first.