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N608 Remark Code: 110% of Medicare Under Act 6

N608 means the allowed amount was calculated at 110% of the Medicare Fee Schedule for the region, specialty, and type of service, in compliance with Act 6. Act 6 is generally understood as the Pennsylvania auto insurance cost-containment law.

Quick facts

Code
N608 (RARC N608)
Status
Active In use since July 15, 2013.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The reduction to the Act 6 allowance. Under that law, providers generally cannot bill the patient for the difference.
Official description
The fee schedule amount allowed is calculated at 110% of the Medicare Fee Schedule for this region, specialty and type of service. This fee is calculated in compliance with Act 6.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N608 means

In Pennsylvania auto injury claims, Act 6 caps what providers are paid for covered medical care, generally at 110% of the applicable Medicare amount. N608 is the carrier’s explanation that it priced your service that way, using the Medicare Fee Schedule for your region, specialty, and type of service.

This is a Pennsylvania property and casualty remark. It usually appears with CARC P23 or CARC 45.

How to check the allowance

  1. Identify the Medicare amount for the service in your region, adjusted for your specialty and service type as the carrier describes.
  2. Multiply by 1.1 and compare with the allowance.
  3. Check modifiers and multiple-procedure rules, which change the Medicare base.
  4. Confirm the date of service so the correct year’s amounts are used.

If you disagree

  • Send the carrier your calculation and ask it to explain its figure.
  • Correct errors in codes, modifiers, or location with a corrected bill.
  • Use Pennsylvania’s dispute options for auto medical bills, including peer review processes for necessity questions, if the carrier won’t adjust.

When there is no Medicare amount for a service, carriers applying Act 6 may use a different method; see N609. For more on reading pricing remarks, see how CARC and RARC codes work together.

Codes that may appear with N608

  • CO-P23 (Medical Payments Coverage (MPC) or Personal Injury Protection (PIP)): A PIP or medical payments jurisdictional fee schedule adjustment.
  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge exceeds the fee schedule or maximum allowable amount.
  • N609 (80% of the provider's billed amount is being recommended for payment according to Act 6.): Under Act 6, 80% of the billed amount is recommended when this rule applies.
  • N599 (Our payment for this service is based upon a reasonable amount pursuant to both the terms and conditions of the policy of insurance under which the…): Florida's no-fault method at 200% of Medicare Part B.
  • N669 (Adjusted based on the Medicare fee schedule.): A general adjustment based on the Medicare fee schedule.

N608 FAQ

What is Act 6?

Pennsylvania's 1990 amendments to its Motor Vehicle Financial Responsibility Law, which limit what providers are paid for auto injury care, generally tying payment to Medicare amounts.

Which Medicare amount is used?

N608 says the fee schedule for the region, specialty, and type of service. Carriers follow Act 6 and its regulations to pick the exact figure, so ask for their calculation if yours differs.

Can I bill the patient the difference?

Generally no. Act 6 limits providers to the calculated amount for covered auto injury care.