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N767 Remark Code: Enroll in Member's Medicaid State

N767 means the patient's state Medicaid program requires the provider to be enrolled in that state's program before any claim can be processed. It usually comes up when treating Medicaid members from another state.

Quick facts

Code
N767 (RARC N767)
Status
Active In use since March 1, 2016.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The provider bears the denial until enrollment is complete. Medicaid members generally cannot be billed for covered services the provider failed to enroll for.
Official description
The Medicaid state requires provider to be enrolled in the member's Medicaid state program prior to any claim benefits being processed.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N767 means

Medicaid is administered by each state, and each state keeps its own provider enrollment. When you treat a patient covered by another state’s Medicaid program, that state typically requires you to enroll with it before it will pay. Federal rules also require state Medicaid programs to screen and enroll the providers they pay, which is one reason this requirement is widespread.

N767 tells you the patient’s state has no active enrollment for you on file. It often pairs with CARC B7, CARC 299, or CARC 185.

Common causes

  • A patient from a neighboring state was treated, and the practice is enrolled only in its home state.
  • A patient on vacation needed urgent care.
  • The practice enrolled in the other state previously, but the enrollment lapsed.
  • The rendering provider is enrolled, but the billing group or facility is not, or the reverse.

How to fix it

  1. Contact the patient’s state Medicaid program, or its managed care plan if applicable, to learn its enrollment process for out-of-state providers.
  2. Submit the enrollment application and ask about retroactive effective dates.
  3. Once enrolled, resubmit the claim within that state’s filing limits, keeping proof of the original submission.
  4. If the patient is in a Medicaid managed care plan, check whether the plan has separate credentialing requirements.

How to prevent it

Identify out-of-state Medicaid coverage at registration and start enrollment immediately for non-emergency care. For practices near state borders, maintaining enrollment in neighboring states avoids repeated N767 denials. See provider enrollment denials for more.

Codes that may appear with N767

  • CO-B7 (This provider was not certified/eligible to be paid for this procedure/service on this date of service.): The provider was not certified or eligible to be paid on this date of service.
  • CO-299 (The billing provider is not eligible to receive payment for the service billed.): The billing provider is not eligible to receive payment.
  • CO-185 (The rendering provider is not eligible to perform the service billed.): The rendering provider is not eligible to perform the service billed.
  • N761 (This provider is not authorized to receive payment for the service(s).): The provider is not authorized to receive payment for broader reasons.
  • N747 (This is a misdirected claim/service.): The claim went to the wrong payer or plan for the patient's residence.
  • N831 (You have not responded to requests to revalidate your provider/supplier enrollment information.): The provider has not responded to revalidation requests.

N767 FAQ

Do I have to enroll in every state's Medicaid program?

Only in states whose Medicaid members you bill. Many states require out-of-state providers to enroll, sometimes with a simplified process for emergency or limited services.

Can enrollment be backdated to the date of service?

Some states allow a retroactive effective date within limits. Ask the state when you apply and submit the application promptly.

Can I bill the Medicaid member instead?

Generally not for covered services. Most states prohibit billing Medicaid members in these situations. Check the state's rules.