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M48 Remark Code (Deactivated): Bill the Hospital

M48 meant that services furnished to hospital inpatients, other than physicians' professional services, could be paid only to the hospital, and the provider had to request payment from the hospital rather than the patient. X12 deactivated it and suggested M97.

X12 deactivated RARCM48 on January 31, 2004. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Code: M48 (RARC M48)
Status: Deactivated StoppedJanuary 31, 2004 (in use since January 1, 1997).
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): Accompanied CO denials; the amount could not be collected from Medicare or the patient.
Official description: Payment for services furnished to hospital inpatients (other than professional services of physicians) can only be made to the hospital. You must request payment from the hospital rather than the patient for this service.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What M48 meant

Under Medicare, most non-physician services provided to a hospital inpatient, such as outside lab work or supplies, are part of the hospital’s payment. Remark M48 told an outside provider who billed Medicare directly that the money had to come from the hospital, and that the patient must not be billed.

What replaced it

X12’s note suggested M97. M97 is active and says the service is not paid to the practitioner in this place of service because payment is included in the facility’s reimbursement. It is commonly paired with CARC CO-97. A claim sent to the wrong contractor altogether may instead get CO-109.

If you still see M48

It is only in older files. For today’s version of the issue, confirm the inpatient dates, then invoice the hospital under your service arrangement. Do not transfer the balance to the patient.

M97 (Not paid to practitioner when provided to patient in this place of service.): The suggested replacement: not paid to the practitioner in this place of service; payment included in the facility's reimbursement.
CO-97 (The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.): The benefit is included in the payment for another service.
CO-109 (Claim/service not covered by this payer/contractor.): Claim not covered by this payer or contractor.

M48 FAQ

Could the patient be billed for these services?

No. M48 specifically said to request payment from the hospital rather than the patient.

How is this different from CARC 98?

CARC 98 was the deactivated adjustment code saying the hospital must file the claim. M48 was the remark code carrying the same message with the added instruction not to bill the patient.

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