Look up another code

N67 Remark Code: Pro Fees Paid to Demo Facility

N67 means the professional services were not paid separately because they are included in the facility's payment under a demonstration project. The provider should seek payment from that facility, or resubmit only in the specific exception situations the remark describes.

Code: N67 (RARC N67)
Status: Active In use since January 1, 2000.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The payer will not pay the professional service directly. The provider should look to the demonstration facility for payment, not the patient.
OA (Other Adjustment): Some payers report it as another adjustment, reflecting that payment is handled through the facility arrangement.
Official description: Professional provider services not paid separately. Included in facility payment under a demonstration project. Apply to that facility for payment, or resubmit your claim if: the facility notifies you the patient was excluded from this demonstration; or if you furnished these services in another location on the date of the patient's admission or discharge from a demonstration hospital. If services were furnished in a facility not involved in the demonstration on the same date the patient was discharged from or admitted to a demonstration facility, you must report the provider ID number for the non-demonstration facility on the new claim.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N67 means

Under some demonstration projects, a payer, often Medicare, pays a participating hospital a single amount that covers both facility and professional services for an episode or stay. Physicians and other professionals then receive their payment from the facility rather than from the payer. N67 tells you your claim fell under such an arrangement, so the payer did not pay your professional services directly.

The remark is usually paired with CARC 132 (prearranged demonstration project adjustment) or CARC 97.

When you can resubmit

The official text lists two exceptions:

The patient was excluded from the demonstration. If the facility notifies you of this, resubmit your claim to the payer.
Services were furnished elsewhere on the day of admission or discharge. If you provided the services at a non-demonstration facility on the date the patient was admitted to or discharged from the demonstration hospital, submit a new claim and report that non-demonstration facility’s provider ID number.

What to do

Confirm the facility and stay dates that triggered the demonstration match your records.
Contact the demonstration facility to arrange payment under its agreement with participating professionals.
Check for an exception. If one applies, gather the facility’s notice or location details.
Submit a new claim in the exception cases, including the non-demonstration facility’s provider ID when required.

How to prevent it

Know which local facilities participate in payer demonstrations and what their payment arrangements are with professionals. Capture the service location precisely on every claim, especially for services on admission and discharge days.

Codes that may appear with N67

CO-132 (Prearranged demonstration project adjustment.): A prearranged demonstration project adjustment.
CO-97 (The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.): The payment for this service is included in the allowance for another service, here the facility's payment.

N68 (Prior payment being cancelled as we were subsequently notified this patient was covered by a demonstration project in this site of service.): A prior payment is being cancelled because the patient was covered by a demonstration project at that site.
MA131 (Physician already paid for services in conjunction with this demonstration claim.): A physician was already paid for services in conjunction with a demonstration claim.
M138 (Patient identified as a demonstration participant but the patient was not enrolled in the demonstration at the time services were rendered.): The patient was identified as a demonstration participant but was not enrolled when services were rendered.

N67 FAQ

Who pays me if the payer does not?

The official remark tells you to apply to the facility for payment. Your agreement with the demonstration facility governs how and how much you are paid.

When can I resubmit to the payer?

According to the remark, if the facility says the patient was excluded from the demonstration, or if you furnished the services at another location on the day of admission to or discharge from the demonstration hospital.

What extra information is needed in that second case?

The remark says to report the provider ID number of the non-demonstration facility on the new claim.

Important: read before using this information

This page is general educational information about a standard industry code set. It is not medical billing, coding, legal, reimbursement, or compliance advice, and it does not create a professional or advisory relationship with ClaimsRevenue.

Code definitions, payer usage, contracts, and laws change, and payers may apply the same code differently. The information is provided “as is,” without warranties of any kind, express or implied, including accuracy, completeness, or currency. You are solely responsible for verifying it against the current official X12 code lists, CMS guidance, your payer contracts, and payer policies before relying on it, and for every billing, coding, collection, and appeal decision you make.

Using this information does not guarantee that any claim will be paid or that any appeal will succeed. To the fullest extent permitted by law, ClaimsRevenue and MOODRX LLC are not liable for any loss or damage arising from its use. Official code descriptions are published by X12 and are quoted for reference only. See our full Claims Validation Disclaimer.