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N546 Remark Code: Prior eRx Reduction Being Paid

N546 means the payment represents a previous reduction based on the Electronic Prescribing (eRx) Incentive Program. In practice, it identifies money being paid back to the provider that had earlier been withheld as an eRx penalty.

Quick facts

Code
N546 (RARC N546)
Status
Active In use since July 1, 2011.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The line reflects a provider-level program adjustment being reversed. It does not affect patient responsibility.
Official description
Payment represents a previous reduction based on the Electronic Prescribing (eRx) Incentive Program.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N546 means

N546 is the unwinding of N545. Under the Medicare eRx Incentive Program, providers classified as unsuccessful e-prescribers had their payments reduced. When that classification was later changed, the earlier reductions could be paid back on reprocessed claims. N546 identifies a payment that corresponds to one of those earlier reductions.

It does not reflect anything wrong with the claim. It is money that had been held back now being released.

How to handle it

  1. Link the payment to the original claim where the eRx reduction was taken.
  2. Reverse the earlier regulatory adjustment in your posting rather than recording the amount as new insurance revenue.
  3. Leave patient balances unchanged. The reduction never affected what the patient owed.
  4. Document the reversal so auditors can see why the claim’s payment changed.

Context

The eRx program ran its penalty phase from 2012 through 2014, so N546 is uncommon in current remittances. It remains useful to recognize when reviewing historical claim data, reconciling legacy accounts, or mapping adjustment codes in a new billing system. Keeping penalty reductions and their reversals in their own adjustment category keeps payment analytics accurate.

Codes that may appear with N546

  • CO-237 (Legislated/Regulatory Penalty.): Legislated or regulatory penalty, the code used for the original reduction.
  • 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…): Mandated law or regulation adjustment used by some payers for program-related amounts.
  • N545 (Payment reduced based on status as an unsuccessful eprescriber per the Electronic Prescribing (eRx)): The original reduction for being an unsuccessful e-prescriber.
  • N552 (Payment adjusted to reverse a previous withhold/bonus amount.): A broader remark for reversing a previous withhold or bonus amount.
  • N699 (Payment adjusted based on the Physician Quality Reporting System (PQRS)): Payment adjusted under the Physician Quality Reporting System.

N546 FAQ

Why would an eRx reduction be paid back?

When a provider's penalty was later overturned, for example after an informal review or an approved hardship exception, previously reduced claims could be adjusted to return the withheld amount.

Do I need to do anything with this payment?

Post it against the original claim as a reversal of the earlier reduction. No appeal or resubmission is needed.

Is the eRx program still running?

No. Its payment adjustments applied from 2012 through 2014, so N546 mainly appears in historical data.