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N828 Remark Code: Payment Suppressed, Contracted Funding

N828 is an alert that payment on the claim was suppressed because the service falls under a contracted funding arrangement. The payer processed the claim but did not send money for it, since funding is handled under a separate agreement.

Quick facts

Code
N828 (RARC N828)
Status
Active In use since March 1, 2020.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The suppressed amount is handled under the funding contract and is not billable to the patient.
  • OA (Other Adjustment): Some payers report the suppressed amount as an other adjustment tied to the funding agreement.
Official description
Alert: Payment is suppressed due to a contracted funding.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N828 means

Some payer-provider relationships don’t use per-claim payment. Under capitation, or a funding arrangement where the provider organization also funds the member’s coverage, the payer still processes each claim for its records but doesn’t send money claim by claim. N828 marks those claims: payment was intentionally suppressed because a contracted funding arrangement covers it.

CARC 139 (contracted funding agreement, subscriber employed by the provider) or CARC 24 (capitation) usually explains the amount.

What to do

  1. Confirm the arrangement applies to this patient and service under your contract.
  2. Post the adjustment to the funding or capitation category, not as a denial or bad debt.
  3. Don’t bill the patient for the suppressed amount.
  4. Check anything that looks wrong. If a patient isn’t part of the funded population, or the service is carved out of the agreement, contact the payer to reprocess. See how CARC and RARC codes work for reading the adjustment lines.

Codes that may appear with N828

  • CO-139 (Contracted funding agreement - Subscriber is employed by the provider of services.): A contracted funding agreement where the subscriber is employed by the provider of services.
  • OA-24 (Charges are covered under a capitation agreement/managed care plan.): Charges are covered under a capitation agreement or managed care plan.
  • N803 (Submission of the claim for the service rendered is the responsibility of the Contracted Medical Group or Hospital.): Claims are the responsibility of a contracted medical group or hospital.

N828 FAQ

Is N828 a denial?

Not in the usual sense. The claim was accepted and processed, but payment is covered under a separate funding arrangement, so no check or EFT is issued for it.

What kind of arrangement is this?

Common examples are capitation or a funding agreement where the provider organization also funds the member's coverage, for instance as the member's employer. Your contract defines it.

Should I still submit these claims?

Usually yes. Payers often need encounter data from these claims even when no payment is made. Follow your contract.