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N364 Remark Code: Deductible or Coinsurance Must Be Waived

N364 is an alert that, under your agreement with the payer, you must waive the patient's deductible and/or coinsurance for this service. Those amounts should not be collected from the patient.

Quick facts

Code
N364 (RARC N364)
Status
Active In use since November 18, 2005; last modified April 1, 2007.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The waived deductible or coinsurance is a contractual adjustment the provider absorbs. It is not the patient's responsibility.
Official description
Alert: According to our agreement, you must waive the deductible and/or coinsurance amounts.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N364 means

Normally, deductible and coinsurance amounts on a remittance are the patient’s to pay. N364 changes that. It tells you the payer’s agreement with you requires those amounts to be waived for this service, so the patient owes nothing for them.

You’ll often see the adjustment under group code CO, sometimes with CARC 281, instead of the usual PR deductible or coinsurance amounts.

What to do

  • Post the waived amount as a contractual adjustment, not as a patient balance.
  • Check for patient payments. If the patient already paid a deductible or coinsurance amount for this service, refund it.
  • Review the contract to confirm which services and plans the waiver applies to, so your system handles future claims correctly.
  • Fix statements that may have gone to the patient before the remittance posted.

Set up a posting rule so lines carrying N364 don’t create patient balances, and train front-desk staff not to collect cost-sharing up front for services covered by the waiver.

Codes that may appear with N364

  • CO-281 (Deductible waived per contractual agreement.): Deductible waived per contractual agreement, reported with group code CO.
  • PR-1 (Deductible Amount): Deductible amount; with N364 it is waived rather than billed to the patient.
  • PR-2 (Coinsurance Amount): Coinsurance amount; the alert says it must be waived under the agreement.
  • N833 (Patient share of cost waived.): States the patient's share of cost has been waived.
  • N381 (Alert: Consult our contractual agreement for restrictions/billing/payment information related to these charges.): Directs you to your contractual agreement for billing and payment restrictions.
  • MA13 (Alert: You may be subject to penalties if you bill the patient for amounts not reported with the PR (patient responsibility) group code.): Warns of penalties for billing patients amounts not reported as patient responsibility.

N364 FAQ

Can I still collect the deductible from the patient?

No. N364 says your agreement requires you to waive it. Collecting it could breach the contract.

Why would an agreement waive patient cost-sharing?

Some network, program, or preventive-care arrangements require the provider to accept the payer's payment in full. The details are in your contract.

What if the patient already paid?

Refund the waived deductible or coinsurance the patient paid for this service, and document the refund.