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M103 Remark Code: New Rental Period at Reduced Level

M103 means the payer accepted a break in therapy, so a new capped rental period begins with this delivery, but the medical information did not support the item as billed. Payment was approved at a reduced level instead.

Code: M103 (RARC M103)
Status: Active In use since January 1, 1997.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The difference between the billed item's allowance and the reduced level is a supplier write-off unless an advance notice applies.
PR (Patient Responsibility): The patient may owe the difference if a valid advance notice covered the upgraded item.
Official description: Information supplied supports a break in therapy. However, the medical information we have for this patient does not support the need for this item as billed. We have approved payment for this item at a reduced level, and a new capped rental period will begin with the delivery of this equipment.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What M103 means

M103 mixes good and bad news for a DME supplier. The good news: the payer agreed there was a genuine break in therapy, so this delivery starts a fresh capped rental period, and prior rental months no longer count against it. The bad news: the payer did not find enough medical information to justify the specific item you billed. It approved payment at a lower level, usually the allowance for a less advanced item it believes meets the patient’s need.

You should track both parts separately: the rental count restarts, and each month’s payment may continue at the reduced amount unless you overturn the reduction.

Common causes

Documentation supports basic equipment but not the upgraded features billed.
The order does not explain why the patient needs a more advanced model.
Records from the prior rental period describe a different level of need than the new order.
Required testing or qualifying information for the higher-level item is missing.

How to fix it

Compare the paid amount with the allowance for the item billed and the lower-level alternative.
Review the order and records for evidence supporting the item’s specific features.
If the record supports the item, appeal with the relevant notes, test results, and a clear explanation of the need.
If it does not, consider whether an advance notice for the upgrade was obtained; if so, the patient may owe the difference.
Reset your rental counter to month one for this delivery regardless of the appeal.

How to prevent it

Confirm documentation supports the exact item before delivery.
Obtain an advance notice when supplying an upgrade that may not be covered.
Track reductions by item type with an ERA Analyzer.

Codes that may appear with M103

CO-150 (Payer deems the information submitted does not support this level of service.): The information submitted does not support the level of item billed.
CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The allowance was reduced to the fee schedule for the lower level of item.

M93 (Information supplied supports a break in therapy.): A break in therapy was accepted and the item was paid as billed, with no reduction.
M94 (Information supplied does not support a break in therapy.): The break in therapy was not accepted, so no new rental period starts.
M25 (The information furnished does not substantiate the need for this level of service.): The information furnished does not substantiate the level of service billed.

M103 FAQ

What does 'reduced level' mean for equipment?

The payer paid for a less advanced or less costly version of the item that it believes meets the patient's documented need, rather than the version billed.

Does the new rental period still start?

Yes. M103 confirms a new capped rental period begins with delivery, even though the monthly payment is at the lower level.

Can I appeal the reduction?

Yes. Submit medical records showing why the patient needs the features of the item billed, not just a basic version.

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