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N844 Remark Code: Nebraska LB997 Emergency Care Act

N844 means all or part of the claim was processed in accordance with Nebraska Legislative Bill 997 (July 24, 2020), the Out of Network Emergency Medical Care Act. The state law shaped the payment and patient cost sharing for out-of-network emergency care.

Quick facts

Code
N844 (RARC N844)
Status
Active In use since March 1, 2021.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • PR (Patient Responsibility): Patient responsibility was calculated under the state law's protections for out-of-network emergency care.
  • CO (Contractual Obligation): Amounts adjusted under the act are not billable to the patient.
Official description
This claim, or a portion of this claim, was processed in accordance with the Nebraska Legislative LB997 July 24, 2020 - Out of Network Emergency Medical Care Act.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N844 means

Nebraska passed LB997, the Out of Network Emergency Medical Care Act, in 2020 to address surprise billing when patients receive emergency care from out-of-network providers. N844 tells you the payer applied that law to all or part of this claim.

Unlike its alert counterpart, N845, N844 states that the claim was actually processed under the act. That means the law shaped the allowed amount or payment and the patient’s cost share on at least some lines. It isn’t a denial; it explains the basis of payment.

Common causes

The code appears because of the claim’s facts, not a billing mistake:

  • Emergency services were furnished by a provider outside the patient’s network.
  • The patient’s plan is subject to Nebraska law, which generally means state-regulated, fully insured coverage.
  • Part of the claim met the act’s conditions and part didn’t, which is why the text says “or a portion of this claim.”

What to do

  1. Identify which lines were processed under the act.
  2. Limit patient billing to the PR amounts reported, and refund any excess already collected.
  3. Review the payment against what the act and state guidance provide.
  4. If you disagree, ask the payer how it calculated payment and use the dispute or appeal process available under the act or the payer’s rules.
  5. Keep Nebraska claims tagged so they aren’t worked like ordinary out-of-network underpayments.

Codes that may appear with N844

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge was reduced to the amount allowed under the state law.
  • PR-2 (Coinsurance Amount): Coinsurance calculated under the act's cost-sharing rules.
  • N845 (Alert: Nebraska Legislative LB997 July 24, 2020 - Out of Network Emergency Medical Care Act.): The alert version of the same Nebraska law reference.
  • N858 (Alert: State regulations relating to an Out of Network Medical Emergency Care Act were applied to the processing of this claim.): A general alert that a state out-of-network emergency care act was applied.
  • N859 (Alert: The Federal No Surprise Billing Act was applied to the processing of this claim.): The Federal No Surprises Act was applied instead.

N844 FAQ

What does the Nebraska act do?

It addresses payment and patient billing for out-of-network emergency medical care in Nebraska. Read the enacted bill and related state guidance for the specific rules.

Can I balance bill the patient?

Generally not beyond the patient responsibility the payer reported. The act exists to protect patients in this situation.

How does it interact with the federal No Surprises Act?

Federal and state surprise billing laws can overlap, and which one governs depends on the plan type and the service. The payer's remark tells you it applied the state law to this claim.