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MA73 Remark Code: Medicare Demo, Patient in Managed Care

MA73 means the remittance is informational and tied to a Medicare demonstration. Original fee-for-service Medicare issued no payment because the patient has elected a Medicare managed care plan.

Quick facts

Code
MA73 (RARC MA73)
Status
Active In use since January 1, 1997.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): No fee-for-service payment is made. Bill the managed care plan rather than writing the service off or billing the patient.
  • OA (Other Adjustment): Some remittances report the amount as an other adjustment because the claim is informational only.
Official description
Informational remittance associated with a Medicare demonstration. No payment issued under fee-for-service Medicare as patient has elected managed care.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA73 means

MA73 appears on Medicare remittances. It says two things: the remittance is informational and associated with a Medicare demonstration, and original fee-for-service Medicare paid nothing because the patient elected managed care. In practice, the claim should be billed to the patient’s Medicare managed care plan (often a Medicare Advantage plan) instead of the fee-for-service contractor.

It is typically paired with CARC 24 (covered under a capitation or managed care arrangement).

Common causes

  • The patient enrolled in a Medicare Advantage or other managed care plan and still presented a red, white, and blue Medicare card.
  • Eligibility was checked before the enrollment took effect.
  • The practice billed fee-for-service Medicare by default for all Medicare-aged patients.

What to do

  1. Verify eligibility for the date of service to identify the managed care plan.
  2. Check plan requirements, such as network status, referrals, and authorization, before billing.
  3. Submit the claim to the managed care plan within its filing limit. Timely filing starts from the plan’s rules, not from Medicare’s remittance; see timely filing.
  4. Update the patient’s registration so future visits go to the correct payer.

How to prevent it

  • Ask Medicare patients at each visit whether they have joined a Medicare Advantage or other plan, and request that card.
  • Run real-time eligibility before every visit rather than relying on the card on file.
  • More prevention steps are in eligibility and COB denials.

Codes that may appear with MA73

  • OA-24 (Charges are covered under a capitation agreement/managed care plan.): Charges are covered under a capitation agreement or managed care plan, the core reason behind MA73.
  • CO-109 (Claim/service not covered by this payer/contractor.): The claim was sent to the wrong payer or contractor and should go elsewhere.
  • N216 (We do not offer coverage for this type of service or the patient is not enrolled in this portion of our benefit package.): The patient is not enrolled in this portion of the payer's benefit package.
  • MA27 (Missing/incomplete/invalid entitlement number or name shown on the claim.): Points to an entitlement number or name mismatch, a member identification problem rather than plan enrollment.
  • N479 (Missing Explanation of Benefits (Coordination of Benefits or Medicare Secondary Payer).): Asks for the explanation of benefits from the patient's other payer.

MA73 FAQ

Can I bill the patient after MA73?

No. The patient has managed care coverage, so the claim should go to that plan. The patient's cost-sharing is determined by the plan.

How do I find the patient's plan?

Run a Medicare eligibility check for the date of service, which shows Medicare Advantage enrollment and the plan, then verify benefits with that plan.

Why does it mention a demonstration?

The official text ties MA73 to a Medicare demonstration project. The billing takeaway is the same: fee-for-service Medicare did not pay because of managed care enrollment.