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M141 Remark Code: Missing Certified Plan of Care

M141 means the payer did not receive a plan of care certified by a physician, which it requires before paying for these services. The payer needs the signed, certified plan, or confirmation that one exists, before the claim can be processed.

Quick facts

Code
M141 (RARC M141)
Status
Active In use since January 1, 1997; last modified February 28, 2003.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The provider is responsible because the required certification was missing. The patient generally should not be billed for this.
Official description
Missing physician certified plan of care.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What M141 means

Some services can only be paid when a physician has reviewed and certified the patient’s plan of care. M141 says that certification was not received. It is usually attached to CARC 16 or an attachment-related reason code, which tells you the claim is missing documentation rather than being denied on its merits.

Medicare uses this requirement for outpatient therapy and home health, where the plan must be certified within set time frames. Other payers may apply similar rules to rehabilitation, skilled nursing, or ongoing treatment programs.

Common causes

  • The plan was sent to the physician for signature but never returned.
  • The plan was certified but not submitted when the payer asked for records.
  • A recertification was due and was not obtained before services continued.
  • The attachment was sent without the claim number or a proper cover sheet, so the payer could not match it.

How to fix it

  1. Locate the certified plan. Confirm that it is signed and dated by the certifying physician and covers the dates of service billed.
  2. Obtain certification if it is missing. Follow the payer’s rules on delayed certification, which may require an explanation of the delay.
  3. Submit the documentation. Use the payer’s attachment process or respond to its additional documentation request, referencing the claim number.
  4. Resubmit if the payer requires it. Some payers need a replacement claim with resubmission code 7 in box 22 once the documentation is ready.
  5. Appeal if it was already on file. If the payer had the plan and missed it, request a reopening or appeal with a copy attached.

How to prevent it

Track certification and recertification dates for every patient on a plan of care, and hold claims until a signed plan is on file. More on handling missing-information denials is in the CO-16 guide.

Codes that may appear with M141

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks information needed for adjudication, and M141 names the missing plan of care.
  • CO-252 (An attachment/other documentation is required to adjudicate this claim/service.): An attachment is required, here the certified plan of care.
  • CO-226 (Information requested from the Billing/Rendering Provider was not provided or not provided timely or was insufficient/incomplete.): The payer requested the plan from the provider and did not receive it, or received it late.
  • N238 (Incomplete/invalid physician certified plan of care.): The plan of care was received but is incomplete or invalid, for example unsigned or out of date.
  • M135 (Missing/incomplete/invalid plan of treatment.): Refers to a plan of treatment more generally, rather than a physician-certified plan of care.
  • M136 (Missing/incomplete/invalid indication that the service was supervised or evaluated by a physician.): Missing indication that the service was supervised or evaluated by a physician.

M141 FAQ

Which services require a certified plan of care?

Under Medicare, outpatient therapy and home health are well-known examples where a physician or other allowed practitioner must certify the plan of care. Other payers set their own rules, so check the policy for the service billed.

What is the difference between M141 and N238?

M141 means the certified plan is missing altogether. N238 means a plan was received but is incomplete or invalid, such as lacking a signature or date.

Do I need to send the plan with the claim?

Not always. Many payers only require the plan to be on file and produced on request. Follow the instructions in the payer's denial or records request.