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N568 Remark Code: Initial NOA Payment, Bundled Model IV

N568 is an informational alert. It tells you the payment on this remittance is the initial payment based on the Notice of Admission (NOA) under the Bundled Payment Model IV initiative, not the final episode payment.

Code: N568 (RARC N568)
Status: Active In use since March 1, 2013.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): Any adjustment reflects the bundled payment model's payment rules. It is not billable to the patient.
OA (Other Adjustment): May appear with an informational adjustment tied to the episode's initial payment.
Official description: Alert: Initial payment based on the Notice of Admission (NOA) under the Bundled Payment Model IV initiative.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N568 means

Under Medicare’s Bundled Payment Model IV, filing a Notice of Admission could trigger an initial payment for the episode before the final claim arrived. N568 labels a payment as that initial NOA-based amount. It is informational: it explains the amount rather than flagging an error.

What to do

Post the payment against the episode, not as a final settlement.
File the interim or final claim on time. If it is late, you may see N560 and a recovery of the initial payment.
Reconcile once the final claim processes to confirm the episode total.

Because the original BPCI models have ended, N568 mostly matters when reconciling older episodes. See how to read CARC and RARC codes for posting guidance.

Codes that may appear with N568

CO-132 (Prearranged demonstration project adjustment.): A prearranged demonstration project adjustment, which describes Model IV payment.

N560 (The pilot program requires an interim or final claim within 60 days of the Notice of Admission.): The pilot required an interim or final claim within 60 days of the NOA.
N562 (The provider number of your incoming claim does not match the provider number on the processed Notice of Admission (NOA) for this bundled payment.): Provider number on the claim does not match the processed NOA.
N561 (The bundled claim originally submitted for this episode of care includes related readmissions.): The bundled claim included related readmissions and can be resubmitted.

N568 FAQ

What was Bundled Payment Model IV?

Model 4 of Medicare's Bundled Payments for Care Improvement initiative, in which a single prospective payment covered hospital and physician services for an inpatient episode. The original BPCI models have since concluded.

Do I need to do anything?

Not in response to the alert itself. Make sure the interim or final claim for the episode is filed on time.

Why is the amount different from my final claim?

The NOA payment is an initial amount. The final episode payment is reconciled when the later claim is processed.

Important: read before using this information

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