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M115 Remark Code: Non-Contract Supplier Denial

M115 means the item was denied because it was provided to this patient by a supplier that is not a contract supplier under the DMEPOS Competitive Bidding Program, or not a participant in the applicable demonstration.

Quick facts

Code
M115 (RARC M115)
Status
Active In use since January 1, 1997; last modified November 5, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The supplier is liable for the denied item. In Medicare's program, a non-contract supplier generally cannot bill the beneficiary unless a specific advance notice rule is met.
Official description
This item is denied when provided to this patient by a non-contract or non-demonstration supplier.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What M115 means

In areas and product categories covered by the Medicare DMEPOS Competitive Bidding Program, only contract suppliers may generally be paid for furnishing those items to beneficiaries who live there. Demonstration projects can impose similar restrictions. M115 tells you that your supplier is not a contract or demonstration supplier for this item and area, so the item is denied.

This is not about the medical need for the item. It is about who furnished it.

Common causes

  • A supplier furnishing a program item to a patient who lives in a competitive bidding area, when the supplier holds no contract for that category and area.
  • The patient’s address recently changed into a bidding area.
  • A grandfathering situation that did not meet all requirements.
  • A product category added in a new contract period that the supplier did not track.

How to fix it

  1. Confirm the patient’s permanent residence and whether it is in a bidding area.
  2. Check your contract status for the product category in that area for the date of service.
  3. If the address was wrong, correct it and resubmit.
  4. If an exception applies, such as grandfathering, submit documentation and request review.
  5. If the denial is valid, follow program rules on beneficiary liability before billing anyone, and help the patient transition to a contract supplier.

How to prevent it

  • Screen every new DME order for the patient’s area and your contract status before delivery.
  • Update your list of program categories each contract period.
  • See provider enrollment denials for other supplier-eligibility issues.

Codes that may appear with M115

  • CO-B7 (This provider was not certified/eligible to be paid for this procedure/service on this date of service.): The supplier was not eligible to be paid for this item on this date of service.
  • CO-96 (Non-covered charge(s).): Non-covered charge, with M115 explaining the supplier contract issue.
  • M114 (This service was processed in accordance with rules and guidelines under the DMEPOS Competitive Bidding Program or a Demonstration Project.): A general notice that competitive bidding or demonstration rules applied.
  • M113 (Our records indicate that this patient began using this item/service prior to the current contract period for the DMEPOS Competitive Bidding Program.): The patient began using the item before the current contract period, which can allow grandfathering.
  • M112 (Reimbursement for this item is based on the single payment amount required under the DMEPOS Competitive Bidding Program for the area where the…): Payment made at the single payment amount, the normal outcome for a contract supplier.

M115 FAQ

Can I bill the patient for an M115 denial?

Under Medicare's competitive bidding rules, non-contract suppliers generally cannot hold the beneficiary liable unless the beneficiary signed a valid advance notice meeting program requirements. Check current rules before billing.

Does grandfathering help?

It may, for certain rental items when the patient was already receiving the item before the contract period and the supplier elected to continue. It does not apply to all items.

What should the patient do?

Obtain the item from a contract supplier for their area, unless an exception applies.