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MA103 Remark Code: Hemophilia Add-On

MA103 indicates the hemophilia add-on applies to the claim. It explains that part of the payment reflects the additional amount made for blood clotting factors furnished to a patient with hemophilia.

Code: MA103 (RARC MA103)
Status: Active In use since January 1, 1997.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): Any adjustment on the line is a provider adjustment. MA103 explains that the hemophilia add-on was part of the calculation.
Official description: Hemophilia Add On.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What MA103 means

MA103 is an informational remark with a two-word official text: “Hemophilia Add On.” In Medicare inpatient payment, hospitals can receive an add-on payment for blood clotting factors given to patients with hemophilia, on top of the standard DRG-based payment. MA103 tells you that add-on factored into the claim.

It is not a denial. It explains part of how the payment was calculated.

What to do

Identify the clotting factor lines on the claim and their HCPCS codes and units.
Compare the payment with your expected DRG payment plus the add-on.
Check the diagnosis supports hemophilia or a related bleeding disorder, since the add-on depends on it.
Contact the payer if the add-on amount seems wrong, especially if units were reduced.

How to prevent payment problems

Make sure clotting factors are charged in the correct billing units, since unit errors directly change the add-on.
Include clotting factor charges on inpatient claims instead of leaving them in pharmacy only.
Check unit-related edits for these drugs; see MUE denials and units of service.

Codes that may appear with MA103

CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): A pricing adjustment on a claim where part of the payment comes from the hemophilia add-on.
CO-94 (Processed in Excess of charges.): Processed in excess of charges, which can happen when add-on payments are applied.

N45 (Payment based on authorized amount.): Payment based on an authorized amount, another explanation of how a payment was calculated.
MA79 (Billed in excess of interim rate.): An interim rate limit on the billed amount.

MA103 FAQ

What is the hemophilia add-on?

Medicare makes a separate add-on payment to hospitals for blood clotting factors furnished to inpatients with hemophilia, beyond the standard inpatient payment.

Do I need to do anything when MA103 appears?

Mainly reconcile. Confirm the clotting factors and units billed match the record and that the add-on amount looks right.

What if the add-on is missing?

Check that the clotting factor was billed with the correct HCPCS code and units, and that the diagnosis supports hemophilia. Contact the payer if the add-on still does not apply.

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