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N157 Remark Code: Transport Destination Not Covered

N157 means transportation to or from this destination is not covered. The payer reviewed where the patient was picked up or taken and found that the trip does not fall within the destinations its benefit covers.

Quick facts

Code
N157 (RARC N157)
Status
Active In use since February 28, 2003; last modified February 1, 2004.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The transport provider absorbs the amount unless the patient was properly notified in advance that it would not be covered.
  • PR (Patient Responsibility): The patient may be responsible for non-emergency trips to non-covered destinations if a valid advance notice was signed.
Official description
Transportation to/from this destination is not covered.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N157 means

Ambulance benefits cover trips between specific kinds of places, not any trip a patient needs. N157 tells you the origin, destination, or combination on the claim fell outside what this payer covers. Trips to a physician’s office, a non-hospital clinic, or a non-medical location are common examples, depending on the payer.

N157 often appears with CARC 96 or CARC 117.

Common causes

  • The origin and destination modifier was keyed wrong, turning a hospital trip into something else.
  • The patient was taken to a location the payer does not recognize as a covered destination.
  • The trip went to a facility beyond the nearest appropriate one, and the payer treats the extra distance or destination as not covered.
  • A round trip was billed as one line with a single modifier.

How to fix it

  1. Check the run report for the actual pickup and drop-off locations.
  2. Verify the modifier on each transport line against those locations.
  3. If the modifier or address was wrong, send a corrected claim with resubmission code 7 in CMS-1500 box 22 and the original claim number.
  4. If the destination was right but necessary (for example, the nearest facility able to provide the care), appeal with the crew’s documentation and physician statements.
  5. Otherwise, handle the balance according to the group code and any advance notice.

How to prevent it

Build destination checks into your dispatch and billing software so a trip’s modifier is derived from the recorded addresses. For scheduled non-emergency trips, confirm the destination is covered before transport.

Codes that may appear with N157

  • CO-96 (Non-covered charge(s).): A non-covered charge, with N157 identifying the destination as the reason.
  • CO-117 (Transportation is only covered to the closest facility that can provide the necessary care.): Transportation is only covered to the closest facility that can provide the necessary care.
  • CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): The trip was not considered medically necessary for that destination.
  • N158 (Transportation in a vehicle other than an ambulance is not covered.): Transport in a vehicle other than an ambulance is not covered.
  • N159 (Payment denied/reduced because mileage is not covered when the patient is not in the ambulance.): Mileage is not covered when the patient is not in the ambulance.
  • N745 (Missing Ambulance Report.): The ambulance report is missing.

N157 FAQ

How does the payer know the destination?

For Medicare and many other payers, ambulance claims carry origin and destination modifiers (a two-letter combination such as residence to hospital) on each transport line, plus pickup and drop-off addresses.

Which destinations are usually covered?

Coverage generally centers on trips to and from hospitals, skilled nursing facilities, dialysis facilities, and the patient's residence when medically necessary. The list and conditions vary by payer.

What if the modifier was wrong?

Correct the origin and destination modifier and resubmit as a corrected claim. A wrong modifier can make a covered trip look non-covered.