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N114 Remark Code: Ambulance Fee Schedule Blended Payment

N114 explains how an ambulance service was paid during the transition to the Ambulance Fee Schedule. Payment was the lesser of a blended amount (part reasonable charge or cost, part fee schedule) or the submitted charge. It is an explanation of pricing, not a denial.

Quick facts

Code
N114 (RARC N114)
Status
Active In use since May 30, 2002.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The difference between the charge and the blended allowance is a contractual reduction the provider absorbs.
  • PR (Patient Responsibility): Deductible and coinsurance on the allowed amount remain the patient's share.
Official description
During the transition to the Ambulance Fee Schedule, payment is based on the lesser of a blended amount calculated using a percentage of the reasonable charge/cost and fee schedule amounts, or the submitted charge for the service. You will be notified yearly what the percentages for the blended payment calculation will be.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N114 means

When Medicare moved ambulance services to a national fee schedule, it phased the change in over several years. During that period, payment was a blend of the old approach (based on reasonable charge or cost) and the new fee schedule amount, with the fee schedule share rising over time. N114 tells you the line was priced with that blend, and that the payment was the lesser of the blended figure or your billed charge.

Today N114 mainly shows up when reviewing historical claims, audits, or payer systems that still apply a comparable blend.

Reading the remittance

  • The allowed amount is the lesser of the blended calculation and the billed charge.
  • A CO-45 reduction reflects the gap between charge and allowance.
  • PR-1 or PR-2 amounts show deductible and coinsurance applied to that allowance.

What to do

  1. Confirm the year’s blend percentages from the payer’s notice for the date of service.
  2. Recalculate the expected allowance from your records of the reasonable charge or cost component and the fee schedule component.
  3. Post the payment if the numbers match.
  4. Request a reopening or appeal if the payer used the wrong year’s percentages or the wrong base amounts, with your calculation attached.

Why it still matters

If you work old accounts, reconcile legacy balances, or respond to audits of that era, N114 explains why the payment differs from a straight fee schedule amount. Recording the blend on your contract notes makes those balances easier to close.

Codes that may appear with N114

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge exceeds the allowed amount; N114 explains the blended method used to set that amount.
  • PR-2 (Coinsurance Amount): Coinsurance calculated on the blended allowance.
  • N159 (Payment denied/reduced because mileage is not covered when the patient is not in the ambulance.): Denies or reduces ambulance mileage when the patient was not aboard.
  • N158 (Transportation in a vehicle other than an ambulance is not covered.): Denies transport in a vehicle that is not an ambulance.
  • N157 (Transportation to/from this destination is not covered.): Denies transport to or from a non-covered destination.

N114 FAQ

Is N114 still used?

The Medicare transition to the Ambulance Fee Schedule was phased in during the 2000s and has ended. You are most likely to see N114 on older remittances, or from a payer still using a similar blended method.

Can I appeal the blended amount?

Only if the payer applied the method incorrectly, such as the wrong percentage or base rate. The method itself is set by payment rules.

Where do the percentages come from?

The official remark notes providers were notified yearly of the percentages used in the blend. Those notices, or the payer's fee schedule publications, show the figures for the year.