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MA125 Remark Code: Payment in Full per Legislation

MA125 means that, under the legislation governing this program, the payer's payment constitutes payment in full. You generally cannot bill the patient for the difference between your charge and the payment.

Quick facts

Code
MA125 (RARC MA125)
Status
Active In use since January 1, 1997.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The difference between the charge and the payment is a provider write-off required by the program's rules.
  • PR (Patient Responsibility): Only the patient responsibility shown, if any, can be collected from the patient; anything beyond it is covered by the payment-in-full rule.
Official description
Per legislation governing this program, payment constitutes payment in full.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA125 means

MA125 tells you the payment on the claim is payment in full because the legislation governing the program says so. Any gap between your charge and the payment, apart from the patient responsibility shown, is not collectible from the patient. It commonly appears alongside CARC 45.

This is not a denial. It is a statement that the payment amount closes out the claim.

Common causes

  • The service falls under a program where the law sets the payment as full payment.
  • Charges are higher than the program’s rates, which is normal.

What to do

  1. Post the difference as a contractual adjustment, not as patient responsibility.
  2. Collect only the patient responsibility reported on the remittance.
  3. Check the payment against the program’s rate for the service.
  4. Request review if the payment is lower than the rate that should apply.

How to prevent problems

  • Flag accounts from programs with payment-in-full rules so staff do not send patients balance bills.
  • Monitor allowed amounts to catch underpayments; an ERA Analyzer makes this easier.
  • More on reading remittances: CARC and RARC denial analysis.

Codes that may appear with MA125

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge exceeds the fee schedule, and MA125 makes clear the payment is full payment.
  • PR-2 (Coinsurance Amount): Coinsurance the patient may owe within the payment-in-full limit.
  • N381 (Alert: Consult our contractual agreement for restrictions/billing/payment information related to these charges.): Points to contract terms rather than legislation as the basis for the payment.
  • N130 (Consult plan benefit documents/guidelines for information about restrictions for this service.): Points to plan benefit documents for restrictions.
  • MA117 (This claim has been assessed a $1.00 user fee.): A user fee assessed on the claim, another program-level adjustment.

MA125 FAQ

Can I balance bill the patient?

No. MA125 means the payment is full payment under the law, so the difference cannot be billed to the patient.

Which programs use MA125?

The official text refers to 'this program' without naming it. It is used where legislation sets the payment as full payment, such as certain government programs.

What if I think the payment itself is too low?

Compare it with the program's fee schedule. If it is lower than it should be, contact the payer and follow its reopening or appeal process.