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N442 Remark Code: Paid Under an Alternate Fee Schedule

N442 means the payment was based on an alternate fee schedule. Instead of the fee schedule you might expect for this service or provider, the payer priced the claim using a different one, which can change the allowed amount.

Quick facts

Code
N442 (RARC N442)
Status
Active In use since July 1, 2008.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The difference between the charge and the allowed amount under the alternate fee schedule is a contractual adjustment, not a patient balance.
  • PR (Patient Responsibility): Cost sharing is calculated on the alternate allowed amount, so the patient's share may differ from what you estimated.
Official description
Payment based on an alternate fee schedule.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N442 means

Payers maintain several fee schedules: different ones for network and out-of-network providers, for facility and non-facility settings, for particular provider types, or for programs like workers’ compensation. N442 says the payer priced this service with an alternate schedule, not the one it would normally apply. The claim was paid, but the allowed amount may not match what you expected.

N442 usually accompanies CARC 45 on the remittance.

Why the payer might switch schedules

  • Provider type or credentials. Services by certain non-physician practitioners may be priced from a different schedule or at a percentage of one.
  • Place of service. Facility and non-facility rates can differ.
  • Network status. The rendering provider was not linked to the contract, so out-of-network pricing applied.
  • Contract terms that reference a different schedule for some services.
  • Jurisdictional rules in workers’ compensation or auto claims.

What to do

  1. Identify the schedule used. Ask the payer which fee schedule it applied and why.
  2. Check your contract or the applicable program fee schedule for the date of service.
  3. Verify provider enrollment. If the rendering provider should have been in-network, confirm enrollment and linkage to the group contract. See provider enrollment denials.
  4. Correct claim data if a wrong place of service, provider, or modifier caused the payer to choose a different schedule, and submit a corrected claim with resubmission code 7.
  5. Dispute the payment if the claim data was right and the payer used the wrong schedule.

How to prevent it

Keep contract fee schedules loaded in your system so underpayments stand out at posting. Tracking N442 by payer and provider over time shows whether the issue is a one-off or a contract setup problem; ERA Analyzer can surface that pattern.

Codes that may appear with N442

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge exceeds the fee schedule or maximum allowable; N442 explains an alternate fee schedule was used.
  • CO-P12 (Workers' compensation jurisdictional fee schedule adjustment.): A workers' compensation jurisdictional fee schedule adjustment, one setting where alternate schedules apply.
  • N448 (This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement.): The service is not included in the fee schedule or contracted fee arrangement at all.
  • N449 (Payment based on a comparable drug/service/supply.): Payment is based on a comparable drug, service, or supply.
  • CO-147 (Provider contracted/negotiated rate expired or not on file.): The provider's contracted or negotiated rate expired or is not on file.

N442 FAQ

Why would a payer use a different fee schedule?

Reasons include the provider's specialty or credentials, the location of service, a network status change, program rules such as workers' compensation, or a contract term that points to another schedule.

Is N442 a denial?

No. It explains how the payment was priced. The claim was paid, possibly at a different rate than expected.

How do I dispute the rate?

Compare the payment with your contract or the applicable fee schedule for that date of service. If it is wrong, contact your provider representative or use the payer's payment dispute process.