Skip to main content

N104 Remark Code: Outside This Contractor's Jurisdiction

N104 means the claim or service was sent to a Medicare contractor that does not process claims for that jurisdiction. The contractor did not decide coverage; you need to identify the correct Medicare Administrative Contractor and submit the claim there.

Quick facts

Code
N104 (RARC N104)
Status
Active In use since January 29, 2002; last modified July 1, 2010.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The claim was returned as misdirected. The amount is not a patient balance; it needs to be billed to the correct contractor.
Official description
This claim/service is not payable under our claims jurisdiction area. You can identify the correct Medicare contractor to process this claim/service through the CMS website at www.cms.gov.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N104 means

Medicare fee-for-service claims are processed by regional contractors, each covering specific states or claim types. N104 tells you the contractor that received your claim has no authority to pay it because the service falls in another contractor’s area. The official remark points you to the CMS website to find the right one.

N104 almost always appears with CARC 109. It is a routing problem, not a coverage decision.

Common causes

  • The service was performed in a state served by a different contractor, often near a state border or at a satellite location.
  • A practice with multiple locations sent all claims through one enrollment, including sites in another jurisdiction.
  • The clearinghouse payer ID was set to the wrong contractor.
  • Durable equipment or supplies were billed to a Part A/B contractor instead of the DME contractor for the beneficiary’s region.
  • The service facility address on the claim did not match where the service happened.

How to fix it

  1. Confirm where the service took place and what kind of claim it is (Part A, Part B, or DME).
  2. Look up the correct contractor for that location and claim type on the CMS website.
  3. Check enrollment. Make sure the billing provider is enrolled with that contractor for the location involved.
  4. Submit a new claim to the correct contractor with the right payer ID. Replacement claims usually cannot be used because the original contractor had no jurisdiction.
  5. Fix the setup in your billing system so the location routes to the correct contractor going forward.

How to prevent it

Map each practice location to its Medicare contractor and payer ID in your billing software, and review the map when you open a new site. Checking service facility addresses before submission catches most routing errors. The provider enrollment guide covers location-level enrollment issues.

Codes that may appear with N104

  • CO-109 (Claim/service not covered by this payer/contractor.): Not covered by this payer or contractor; send the claim to the correct one. This is the usual partner for N104.
  • CO-B11 (The claim/service has been transferred to the proper payer/processor for processing.): Used when the claim has been transferred to the proper processor instead of being returned.
  • N105 (This is a misdirected claim/service for an RRB beneficiary.): A misdirected claim for a Railroad Retirement Board beneficiary.
  • N127 (This is a misdirected claim/service for a United Mine Workers of America (UMWA) beneficiary.): A misdirected claim for a United Mine Workers of America beneficiary.
  • N747 (This is a misdirected claim/service.): Directs you to the payer or plan where the patient resides.

N104 FAQ

How is Medicare jurisdiction determined?

For most Part B professional claims it follows where the service was furnished and where the provider is enrolled. Some suppliers, such as DME suppliers, are assigned by different rules, often tied to the beneficiary's residence.

Does filing with the wrong MAC protect the timely filing deadline?

Do not rely on it. Refile with the correct contractor as soon as possible and keep the N104 remittance as a record of the original submission.

Do I need to enroll with the other contractor?

Possibly. If you furnish services in another jurisdiction, you may need enrollment there before that contractor can pay you.