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N353 Remark Code: Benefits Estimated Before Service

N353 is an alert that the benefits shown are an estimate, typically from a predetermination. The payer will consider additional payment once the services are actually rendered and you submit a claim for them.

Quick facts

Code
N353 (RARC N353)
Status
Active In use since August 1, 2005; last modified April 1, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Any amount shown is an estimate under the provider's contract, not a final payment. The final allowed amount is set when the claim for completed services is processed.
Official description
Alert: Benefits have been estimated, when the actual services have been rendered, additional payment will be considered based on the submitted claim.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N353 means

N353 appears on responses to predetermination or pre-treatment estimate requests, most often in dental care and occasionally for planned medical services. The payer has looked at the proposed treatment and estimated what the plan would pay. The alert reminds you that no payment is being made yet. When the services are completed and billed, the payer will decide what to pay.

It usually sits next to CARC 101, which describes the same idea from the adjustment side.

What to do

  • Nothing on this response. It isn’t a denial and needs no appeal.
  • Share the estimate with the patient as an estimate, making clear that it can change.
  • Bill after treatment. Submit a normal claim with the actual dates of service once the work is done. Some payers ask you to reference the predetermination number, so check their instructions.
  • Recheck eligibility before starting treatment if much time has passed since the estimate, since coverage or remaining benefits may have changed.

Store the estimate with the treatment plan so the billing team can compare the final payment to it and follow up on large differences.

Codes that may appear with N353

  • CO-101 (Predetermination: anticipated payment upon completion of services or claim adjudication.): Predetermination: anticipated payment upon completion of services or claim adjudication, the usual partner for this alert.
  • N360 (Alert: Coordination of benefits has not been calculated when estimating benefits for this pre-determination.): Says coordination of benefits was not calculated in a predetermination estimate.
  • N183 (Alert: This is a predetermination advisory message, when this service is submitted for payment additional documentation as specified in plan…): A predetermination advisory that more documentation may be needed when the service is billed.
  • N133 (Alert: Services for predetermination and services requesting payment are being processed separately.): Notes that predetermination services and services requesting payment are processed separately.

N353 FAQ

Is the estimate a promise of payment?

No. An estimate does not guarantee payment. Eligibility, remaining benefits, and plan terms are rechecked when the actual claim is processed.

Do I need to send anything now?

No. Submit a regular claim after the services are performed, with the actual dates of service.

Can the final payment differ from the estimate?

Yes. Changes in the treatment performed, other coverage, or benefits used in the meantime can change the amount.