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MA26 Remark Code: You Were Previously Informed of This Rule

MA26 is an alert telling you that the payer's records show you were previously informed of the rule that was applied to this claim. It is typically used to support holding the provider liable, since the provider can no longer claim it did not know.

Quick facts

Code
MA26 (RARC MA26)
Status
Active In use since January 1, 1997; last modified April 1, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The provider is responsible. MA26 reinforces that the provider was on notice and cannot shift the amount to the patient.
Official description
Alert: Our records indicate that you were previously informed of this rule.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA26 means

MA26 does not describe a new problem. It points to history: the payer says it has already told you about the rule behind this denial or reduction, whether through an earlier remittance alert, a letter, or published guidance. In Medicare’s limitation-of-liability framework, a provider who knew a service would not be covered generally cannot pass that cost to the patient.

The reason code beside MA26 tells you which rule applied.

What to do

  1. Read the paired CARC to identify the rule.
  2. Review your earlier notices to confirm what you were told and when.
  3. Do not bill the patient for CO amounts tied to the rule unless a valid advance notice shifted liability.
  4. Appeal only with a strong basis, such as evidence the rule did not apply to this service.
  5. Fix the workflow that allowed the same issue to repeat.

Recurring denials after prior notice point to a process gap. Grouping them by reason code, as described in CARC and RARC denial analysis, shows where to start.

Codes that may appear with MA26

  • CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): A medical necessity denial where prior notice of the policy affects who bears liability.
  • CO-96 (Non-covered charge(s).): A non-covered charge under a rule the provider had been told about.
  • CO-242 (Services not provided by network/primary care providers.): Services from outside the network after prior notification.
  • MA14 (Alert: The patient is a member of an employer-sponsored prepaid health plan.): The one-time payment alert that serves as the earlier notice for prepaid plan members.
  • MA13 (Alert: You may be subject to penalties if you bill the patient for amounts not reported with the PR (patient responsibility) group code.): Warns of penalties for billing patients amounts outside PR.
  • N211 (Alert: You may not appeal this decision.): An alert that the decision cannot be appealed.

MA26 FAQ

Why does prior notice matter?

Liability rules often depend on whether the provider knew, or should have known, that a service would not be paid. Prior notice removes that defence.

Can I still appeal?

Yes, if you believe the rule was applied wrongly to this service. The alert does not remove appeal rights on its own.

What if we never received the earlier notice?

Ask the payer for a copy or the date of the prior notice. If it went to an old address or another entity, include that in any appeal.