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N44 Remark Code (Deactivated): Surcharges Paid to Regulator

N44 meant the payer paid its share of regulatory surcharges, assessments, allowances, or health care-related taxes directly to the regulatory authority. X12 deactivated it and suggested reason code 137.

X12 deactivated RARCN44 on October 16, 2003. Payers should no longer use it on new remittances, but it can still appear on older ERAs, corrected claims, and appeals.

Code: N44 (RARC N44)
Status: Deactivated StoppedOctober 16, 2003 (in use since January 1, 2000).
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The surcharge amount was not paid to the provider and was not a patient balance.
Official description: Payer's share of regulatory surcharges, assessments, allowances or health care-related taxes paid directly to the regulatory authority.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N44 meant

In some states, health care claims carry regulatory surcharges or taxes. Remark N44 explained that the payer’s portion of such a charge had been sent straight to the regulatory authority rather than to the provider. It accounted for a difference that would otherwise look like a short payment.

What replaced it

X12’s note suggests reason code 137. CO-137 reports regulatory surcharges, assessments, allowances, or health-related taxes as an adjustment. The active remark N733 says regulatory surcharges are paid directly to the state. Other legally mandated adjustments can use CO-223.

If you still see N44

It only exists in older remittances. Post the amount as a regulatory adjustment rather than a write-off against your contract, and follow your state’s rules on how surcharges are handled on patient statements.

CO-137 (Regulatory Surcharges, Assessments, Allowances or Health Related Taxes.): The suggested replacement: regulatory surcharges, assessments, allowances, or health-related taxes.
N733 (Regulatory surcharges are paid directly to the state.): Regulatory surcharges are paid directly to the state.
CO-223 (Adjustment code for mandated federal, state or local law/regulation that is not already covered by another code and is mandated before a new code…): Adjustment code for mandated federal, state, or local law not covered by another code.

N44 FAQ

What kinds of surcharges does this involve?

Some states require payers or providers to pay surcharges or assessments on health care services to fund state programs. N44 told the provider the payer paid its share directly to the state.

Should the provider do anything?

Usually not beyond posting. The amount reflects money sent to the regulator, so it should not be billed to the patient or treated as underpayment.

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