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MA79 Remark Code: Billed in Excess of Interim Rate

MA79 means the billed amount was higher than the interim rate the payer applies to this provider, so the payer adjusted the excess. Interim rates are provisional payment rates that are later reconciled.

Quick facts

Code
MA79 (RARC MA79)
Status
Active In use since January 1, 1997.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The excess over the interim rate is a provider adjustment and is not billable to the patient.
Official description
Billed in excess of interim rate.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA79 means

Some payers pay certain providers, mainly institutional ones, using an interim rate: a provisional rate that stands in until final payment is settled, for example through a cost report. MA79 tells you your billed amount was higher than that interim rate, so the payer paid at the interim level and adjusted the rest. It typically explains a CARC 45 adjustment.

This is a pricing explanation, not a sign that the claim was wrong.

Common causes

  • Charges are set above the interim rate, which is normal and expected.
  • The payer applied an outdated interim rate after a rate change.
  • The claim was priced under the wrong provider number or facility, picking up another rate.

What to do

  1. Confirm the interim rate that should apply for the dates of service.
  2. Compare the payment on the remittance to that rate.
  3. Post the excess as a contractual adjustment if the rate was correct.
  4. Contact the payer if an outdated or incorrect rate was used, and ask for reprocessing.
  5. Track interim payments so they reconcile cleanly at settlement.

How to prevent problems

  • Keep a record of every interim rate notice and its effective date.
  • Load rate changes promptly so expected-payment variance reports stay accurate.
  • An ERA Analyzer review comparing paid amounts to expected rates can catch a stale interim rate early.

Codes that may appear with MA79

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge exceeded the allowed amount; MA79 explains that the limit is an interim rate.
  • CO-94 (Processed in Excess of charges.): Processed in excess of charges, sometimes seen when interim and final amounts are reconciled.
  • MA93 (Non-PIP (Periodic Interim Payment) claim.): Identifies a claim that is not paid under periodic interim payment, another interim-payment concept.
  • N381 (Alert: Consult our contractual agreement for restrictions/billing/payment information related to these charges.): Points to contract terms as the basis for a pricing reduction.

MA79 FAQ

What is an interim rate?

A provisional rate a payer uses to pay claims during a period, often for institutional providers, with the final amount determined later through reconciliation or cost settlement.

Can I bill the patient for the difference?

No. Under the CO group code, the excess is a provider adjustment.

Should I appeal MA79?

Only if the interim rate applied is not the one you were assigned. Otherwise the difference is addressed in the later reconciliation, not claim by claim.