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N817 Remark Code: Lab Private Payor Data Reporting

N817 is an alert reminding applicable laboratories that they must collect private payor payment data and report it to CMS. The text names a January 1 to March 31, 2020 reporting window, which later legislation delayed, so check CMS for current requirements.

Quick facts

Code
N817 (RARC N817)
Status
Active In use since July 1, 2019.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The alert itself doesn't create an adjustment. Any CO amount on the line is explained by the accompanying CARC.
Official description
Alert: Applicable laboratories are required to collect and report private payor data and report that data to CMS between January 1, 2020 - March 31, 2020.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N817 means

Medicare sets many clinical laboratory fee schedule rates using what private payers actually pay labs. To get that data, CMS requires applicable laboratories to report their private payor rates and volumes during defined reporting periods. N817 was created as a remittance reminder about one such period, January through March 2020.

The alert doesn’t change the claim. It rides along on lab claims as a notice to the lab’s billing and compliance staff.

What to do

  1. No claim action is needed for the alert itself. Handle any adjustment on the line according to its CARC.
  2. Route the notice to whoever handles CMS lab reporting so they can confirm whether your lab is an applicable laboratory.
  3. Check CMS’s current guidance. The reporting window in the alert text was postponed by later legislation, so rely on CMS’s clinical laboratory fee schedule resources for current dates and requirements.
  4. Keep private payor remittance data organized by test code and payer, since that is what reporting relies on.

Codes that may appear with N817

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The lab service was paid under the fee schedule, and the alert rode along as a reminder.
  • CO-B23 (Procedure billed is not authorized per your Clinical Laboratory Improvement Amendment (CLIA) proficiency test.): A lab service denied because it isn't authorized under the lab's CLIA proficiency testing.
  • M126 (Missing/incomplete/invalid individual lab codes included in the test.): Individual lab codes in a test were missing or invalid.

N817 FAQ

Does N817 affect how the claim paid?

No. It is an informational reminder. Any reduction on the line comes from the CARC reported with it.

Which laboratories does it apply to?

It is aimed at laboratories that meet CMS's definition of an applicable laboratory for clinical lab fee schedule reporting. Whether your lab qualifies depends on criteria CMS sets, including how much of its Medicare revenue comes from lab services.

Is the 2020 reporting window still in effect?

No. Congress delayed the reporting period more than once after that alert was created. Check CMS's clinical laboratory fee schedule pages for the current reporting schedule.