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N448 Remark Code: Not in Fee Schedule or Contract

N448 means the drug, service, or supply billed is not included in the fee schedule or the contracted or legislated fee arrangement. The payer has no rate for it under the arrangement that governs this claim, so it did not pay or adjusted the line.

Quick facts

Code
N448 (RARC N448)
Status
Active In use since July 1, 2008; last modified March 14, 2014.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The line is adjusted under contract or fee schedule terms. The provider generally cannot bill the patient for it.
  • PR (Patient Responsibility): Less commonly, where the item falls outside the benefit and the patient agreed in advance, the amount may be patient responsibility.
Official description
This drug/service/supply is not included in the fee schedule or contracted/legislated fee arrangement.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N448 means

Payers pay from rate tables: a fee schedule, a contract rate sheet, or a legislated schedule such as a state workers’ compensation fee schedule. N448 means the item on this claim line does not appear in whichever table governs the claim. With no rate, the payer either denies the line or adjusts it.

N448 is typically paired with CARC 45 or CARC 96, and with CARC P7 in property and casualty settings.

Common causes

  • New code. The code was recently added to HCPCS or another code set, and the payer has not assigned a rate.
  • Contract gap. Your contract lists specific codes and this one was left out.
  • Wrong code. The item was billed with a code that does not fit it, and the correct code would be on the schedule.
  • Jurisdictional fee schedule limits. The state fee schedule does not include the code, and rules for pricing unlisted items apply.
  • Code not valid for the date of service, so the payer’s schedule for that date has no entry.

What to do

  1. Verify the code. Confirm it is the most accurate code for the item and was valid on the date of service.
  2. Check the governing schedule for the payer or jurisdiction.
  3. If the code was wrong, correct it and submit a corrected claim with resubmission code 7.
  4. If the code was right, ask the payer how it prices items not on its schedule. Some require an invoice or description; others pay a percentage of charges.
  5. For contracted payers, raise the gap with your provider representative so it can be fixed going forward.

How to prevent it

When you add new services or supplies, check that each major payer has a rate before you start billing them. Keep a list of codes that repeatedly return N448 and include them in your next contract discussion.

Codes that may appear with N448

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge exceeds the fee schedule or maximum allowable; N448 adds that no fee exists for the item.
  • CO-96 (Non-covered charge(s).): Non-covered charge because the item has no fee under the arrangement.
  • CO-P7 (The applicable fee schedule/fee database does not contain the billed code.): In property and casualty claims, the fee schedule does not contain the billed code.
  • N442 (Payment based on an alternate fee schedule.): The payer used an alternate fee schedule to price the item.
  • N449 (Payment based on a comparable drug/service/supply.): Payment based on a comparable drug, service, or supply.
  • CO-189 ('Not otherwise classified' or 'unlisted' procedure code (CPT/HCPCS) was billed when there is a specific procedure code for this procedure/service): An unlisted or not otherwise classified code was billed when a specific code exists.

N448 FAQ

Why would a valid code not be on the fee schedule?

New codes may not be loaded yet, some codes are intentionally excluded from a contract, and some jurisdictions' fee schedules don't list every code.

Should I switch to an unlisted code?

Only if no specific code accurately describes the item. Replacing a correct specific code with an unlisted one to force pricing can trigger other denials.

Can I negotiate a rate?

For contracted payers, yes. Ask your provider representative to add the code to your fee schedule, especially for services you perform often.