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MA131 Remark Code: Physician Already Paid, Demo Claim Held

MA131 means a physician has already been paid for services connected with this demonstration claim. Before the payer processes your claim, the physician must withdraw their claim and refund the payment.

Quick facts

Code
MA131 (RARC MA131)
Status
Active In use since October 12, 2001.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Your claim is on hold due to a conflicting physician payment. It is a provider-to-provider issue, not a patient liability.
Official description
Physician already paid for services in conjunction with this demonstration claim. You must have the physician withdraw that claim and refund the payment before we can process your claim.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA131 means

MA131 applies to demonstration projects where a single claim covers services that would normally be billed separately, including physician services. It says a physician has already been paid separately for services in conjunction with this demonstration claim. The payer will not process your claim until that physician withdraws their claim and refunds the payment.

This is effectively a duplicate-payment prevention rule across providers.

Common causes

  • The physician billed their services separately, unaware they were included in the demonstration.
  • The physician’s claim was processed before yours.
  • Communication between the demonstration site and participating physicians broke down.

What to do

  1. Identify the physician and the claim that was paid.
  2. Coordinate the withdrawal with the physician’s billing office, including the refund.
  3. Confirm the refund has been processed by the payer.
  4. Resubmit or request reprocessing of your claim according to the payer’s instructions.

How to prevent it

  • Share demonstration participation details with every physician who treats demonstration patients.
  • Agree on who bills which services before care starts.
  • For more on overlapping and duplicate claims, see CO-18 duplicate claims.

Codes that may appear with MA131

  • CO-B20 (Procedure/service was partially or fully furnished by another provider.): The service was partially or fully furnished and paid through another provider.
  • OA-18 (Exact duplicate claim/service (Use only with Group Code OA except where state workers' compensation regulations requires CO)): An exact duplicate claim or service, similar in that the service was already paid.
  • MA80 (Informational notice.): An informational notice that the hospital was paid for all services in the encounter under a demonstration.
  • MA132 (Adjustment to the pre-demonstration rate.): An adjustment to the pre-demonstration rate.

MA131 FAQ

Who needs to act on MA131?

Your organization needs to coordinate with the physician who was paid. The physician must withdraw their claim and refund the payment, as the official text states.

Should I resubmit my claim?

Wait until the physician's claim is withdrawn and the payment refunded, then follow the payer's instructions on reprocessing or resubmitting.

Why was the physician paid separately?

Under a demonstration that bundles payment, physician services may be included in a single payment. If the physician billed separately first, their claim was paid before yours was received.