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N809 Remark Code: Fee Set From Prior Bidding Rates

N809 is an alert that the fee schedule amount used to pay this item was adjusted based on prior competitive bidding rates. It explains the price, most often on DMEPOS claims, and points you to your local contractor for details.

Code: N809 (RARC N809)
Status: Active In use since November 1, 2018.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The difference between the billed charge and the adjusted fee schedule amount is a provider write-off.
Official description: Alert: The fee schedule amount for this service was adjusted based on prior competitive bidding rates. For more information, contact your local contractor.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N809 means

Medicare’s DMEPOS Competitive Bidding Program set prices for certain equipment and supplies through supplier bids. Those bid results have also been used to adjust the regular fee schedule amounts for the same items, including in places where no bidding program was running. N809 tells you that the fee schedule amount applied to your line came from that adjustment.

This is an alert, not a denial. The line was priced and paid; the remark explains where the price came from. It commonly appears with CARC 45.

What to do

Confirm the payment matches the published fee for the HCPCS code, modifiers, and the beneficiary’s area on the date of service.
If it matches, post the difference as a contractual adjustment.
If it doesn’t, check that the patient’s address and the code and modifiers were reported correctly, since both drive pricing. Contact your contractor if the amount still looks wrong.
Watch for trends. A drop in allowed amounts across many lines usually means a fee schedule update, which ERA analysis makes easy to spot.

Codes that may appear with N809

CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge exceeded the fee schedule amount, which was set using prior bidding rates.

M112 (Reimbursement for this item is based on the single payment amount required under the DMEPOS Competitive Bidding Program for the area where the…): Payment is based on the single payment amount inside a competitive bidding area.
M114 (This service was processed in accordance with rules and guidelines under the DMEPOS Competitive Bidding Program or a Demonstration Project.): The claim was processed under competitive bidding program rules.

N809 FAQ

Does N809 mean I'm in a competitive bidding area?

Not necessarily. Medicare has used information from competitive bidding to adjust DMEPOS fee schedule amounts in areas outside competitive bidding programs as well. The alert simply explains how the fee was set.

Can I appeal an N809 payment?

The pricing method itself generally isn't appealable. If you think the wrong amount was applied, for example the wrong area or code, contact your contractor.

Where can I see the adjusted fee?

Your DME contractor publishes the applicable fee schedule amounts, and the alert text directs you to the local contractor for more information.

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.

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