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N526 Remark Code: No Recovery Due to Employer Size

N526 means the payer does not qualify for recovery based on employer size. Under Medicare Secondary Payer rules, an employer plan is primary to Medicare only when the employer meets certain size thresholds, and the plan is stating that this employer does not.

Quick facts

Code
N526 (RARC N526)
Status
Active In use since March 1, 2010.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • OA (Other Adjustment): The remark reflects a coordination of benefits or recovery determination rather than a charge adjustment the provider made.
  • CO (Contractual Obligation): When it appears on a provider claim, it signals the plan is not primary. The provider should bill the correct primary payer rather than the patient.
Official description
Not qualified for recovery based on employer size.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N526 means

Medicare Secondary Payer (MSP) law makes certain employer group health plans pay before Medicare. Size is one of the tests. Small employers’ plans are generally secondary to Medicare, while larger employers’ plans can be primary, depending on why the person has Medicare.

N526 belongs to a small group of remarks (N526, N527, and N530 through N532) whose wording centers on recovery: Medicare, or its recovery contractor, is trying to recoup payments it believes an employer plan should have made first. With N526 the plan answers that it is not liable because the employer is too small for the MSP rules to make it primary.

When providers see it

Most N526 activity happens between plans and Medicare’s recovery operation. If it appears on a provider remittance, the plan is effectively saying it is not the primary payer for a Medicare beneficiary because of employer size.

What to do

  1. Confirm the patient’s Medicare entitlement basis: age, disability, or ESRD.
  2. Confirm employer size information with the patient or plan if it looks wrong.
  3. Update coordination of benefits in your system, and report corrections to Medicare’s Benefits Coordination and Recovery Center if Medicare’s records are wrong.
  4. Bill the correct primary payer, usually Medicare in this situation, then send the employer plan the secondary claim with Medicare’s remittance.
  5. Watch filing limits on the payer you now need to bill first.

How to prevent it

Use a Medicare Secondary Payer questionnaire at registration for Medicare patients with employer coverage, including employer size. See eligibility and COB denials for common payer-order mistakes.

Codes that may appear with N526

  • OA-22 (This care may be covered by another payer per coordination of benefits.): The care may be covered by another payer, here Medicare, under coordination of benefits.
  • CO-109 (Claim/service not covered by this payer/contractor.): The claim is not covered by this payer and should go to the correct one.
  • N532 (Not qualified for recovery based on disability and working status.): Not qualified for recovery because of disability and working status, a separate MSP test.
  • N534 (This is an individual policy, the employer does not participate in plan sponsorship.): The coverage is an individual policy with no employer sponsorship.
  • N530 (Not Qualified for Recovery based on enrollment information.): Not qualified for recovery based on enrollment information.

N526 FAQ

What employer size thresholds apply?

For Medicare beneficiaries entitled by age, an employer plan is generally primary when the employer has 20 or more employees. For those entitled by disability, the threshold is generally 100 or more. End-stage renal disease cases follow a coordination period regardless of employer size.

Who decides which payer is primary?

Payers apply the rules to the facts they have. CMS's Benefits Coordination and Recovery Center maintains Medicare's records of other coverage.

What should a provider do with N526?

Treat it as a statement that the employer plan is secondary to Medicare. Confirm with the patient and payers, update COB records, and bill Medicare as primary if appropriate.