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N68 Remark Code: Payment Cancelled, Demo Project Site

N68 means the payer is cancelling a prior payment because it later learned the patient was covered by a demonstration project at the site of service. Professional services were included in the facility's payment, so the provider must seek payment from the facility and refund prior payments as the remark instructs.

Code: N68 (RARC N68)
Status: Active In use since January 1, 2000.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The reversed payment is the provider's adjustment. The provider should pursue the facility, not the patient, for payment.
OA (Other Adjustment): Some payers report the reversal as another adjustment tied to the demonstration arrangement.
Official description: Prior payment being cancelled as we were subsequently notified this patient was covered by a demonstration project in this site of service. Professional services were included in the payment made to the facility. You must contact the facility for your payment. Prior payment made to you by the patient or another insurer for this claim must be refunded to the payer within 30 days.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N68 means

N68 is the after-the-fact version of N67. The payer originally paid your professional claim, then learned the patient was part of a demonstration project at the site of service. Under that demonstration, the facility’s payment already covered professional services. The payer is now cancelling its payment and telling you to contact the facility for yours.

The official wording also directs that any payment you received from the patient or another insurer for this claim be refunded to the payer within 30 days. This remark usually accompanies CARC 132 or CARC 97 on a reversal.

Common causes

Demonstration enrollment was reported to the payer after your claim was paid.
The facility’s claim, identifying the demonstration stay, processed after yours.
Your claim did not indicate a demonstration facility as the service location.

What to do

Post the reversal and track any offset against future payments.
Verify the demonstration stay with the facility, including dates and the patient’s participation.
Arrange payment from the facility under its agreement with professionals.
Handle refunds promptly. If you collected from the patient or another insurer, follow the remark’s instruction to refund the payer within the stated time, and document the refund.
Dispute errors. If the patient was not in the demonstration, or your services were at another site, provide evidence and ask for reprocessing.

How to prevent it

Coordinate with demonstration facilities to learn which patients are enrolled before billing, and record the service location accurately. Monitoring reversals with the ERA Analyzer helps you spot recoupments tied to demonstration programs.

Codes that may appear with N68

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

N67 (Professional provider services not paid separately.): Professional services not paid separately because they are included in the demonstration facility's payment.
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.
M116 (Processed under a demonstration project or program.): Processed under a demonstration project that is ending.

N68 FAQ

What refund does N68 require?

The official text says any prior payment made to you by the patient or another insurer for the claim must be refunded to the payer within 30 days. Read your remittance and any accompanying letter for specific instructions.

Will the payer take back its own payment?

Yes. N68 cancels the payer's prior payment, which usually appears as a reversal and may be offset against future payments.

What if I disagree that the patient was in the demonstration?

Contact the facility and the payer to verify enrollment and dates. If the patient was excluded, you may be able to have the claim reprocessed.

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