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M116 Remark Code: Demonstration Project Is Ending

M116 means the claim was processed under a demonstration project or program that is ending. Additional services may not be paid under that project or program, so future claims may follow different rules.

Quick facts

Code
M116 (RARC M116)
Status
Active In use since January 1, 1997; last modified March 8, 2011.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Any adjustment on this claim follows the project's rules; after it ends, payment follows the payer's standard rules.
  • PR (Patient Responsibility): Patient cost-sharing on this claim is calculated under the project's terms.
Official description
Processed under a demonstration project or program. Project or program is ending and additional services may not be paid under this project or program.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What M116 means

Payers, including Medicare, sometimes test new payment or coverage approaches through demonstration projects or time-limited programs. These projects have end dates. M116 tells you that this claim was processed under such a project, and that the project is wrapping up. Services furnished after it ends may not be paid under the same terms, or at all.

M116 is essentially an early warning. The current claim is handled; the concern is the next one.

When you see it

  • You participate in a demonstration or special program nearing its end date.
  • The payer has announced the program’s close and is notifying providers through remittances.
  • The service is one that the program specifically covered or priced.

What to do

  1. Confirm the claim result using the CARC and payment.
  2. Find the end date and transition rules in the payer’s notices.
  3. Identify affected patients who receive ongoing services under the project.
  4. Plan the transition, including whether services will be covered under standard rules, need prior authorization, or require patient notice.
  5. Update billing rules so claims after the end date use the correct codes, modifiers, and pricing.

How to prepare

  • Keep a list of programs your practice participates in, with their end dates.
  • Review payer bulletins regularly; M116 is often the last reminder, not the first.
  • Watch for payment shifts after the end date with an ERA Analyzer.

Codes that may appear with M116

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge was reduced to the project's payment amount.
  • PR-2 (Coinsurance Amount): Coinsurance applied under the project's rules.
  • 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 project rules applied.
  • M115 (This item is denied when provided to this patient by a non-contract or non-demonstration supplier.): Denial for a non-contract or non-demonstration supplier.

M116 FAQ

Does M116 mean my claim was denied?

No. This claim was processed under the project. M116 warns that the project is ending and later services may not be paid the same way.

How do I find out when the project ends?

Check the payer's announcements or contact the contractor that administers the demonstration.

What happens to ongoing patients?

It depends on the project's transition rules. Some services may move to standard payment, and some may no longer be covered.