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N861 Remark Code: Share of Cost Doesn't Match Records

N861 is an alert that the patient liability or share-of-cost amount you reported on the claim doesn't match the amount the payer has on record for this recipient. It's most common in Medicaid programs, where members may owe a monthly share of cost or patient liability.

Code: N861 (RARC N861)
Status: Active In use since March 1, 2022.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: PR (Patient Responsibility): The payer applied its own record of the member's liability, which may differ from what you reported.
CO (Contractual Obligation): Any difference the payer didn't recognize generally can't be billed to the member without confirming the correct amount.
Official description: Alert: Mismatch between the submitted Patient Liability/Share of Cost and the amount on record for this recipient.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N861 means

Some Medicaid members must contribute toward their care each month. The amount is set by the state and is called patient liability or share of cost depending on the program. Providers such as nursing facilities often report it on the claim. N861 is an alert that the amount you reported didn’t match what the payer has on file for the member.

The payer typically applies its own figure, so the payment and patient responsibility on the remittance may differ from what you expected.

What to do

Compare your amount with the state eligibility record for the month of service.
If your figure was wrong, update the patient account and correct future claims. Send a corrected claim if the payer requires it.
If the payer’s record is outdated, work with the member or caseworker to get the state to update it, then ask the payer to reprocess.
Bill the member only the amount the payer recognized until the discrepancy is resolved.

Codes that may appear with N861

PR-142 (Monthly Medicaid patient liability amount.): Monthly Medicaid patient liability amount, adjusted to the amount on record.

N833 (Patient share of cost waived.): The patient's share of cost was waived.
N58 (Missing/incomplete/invalid patient liability amount.): The patient liability amount on the claim is missing, incomplete, or invalid.

N861 FAQ

Which amount is right, mine or the payer's?

The payer's record usually comes from the state's eligibility system. If you believe it's outdated, the member or their caseworker may need to update it with the state.

Where does the liability amount come from?

Often from the state Medicaid eligibility determination, such as for nursing facility residents. The eligibility response for the month typically shows it.

Do I need to resubmit?

Only if you reported the wrong amount and the payer's processing depends on it. Otherwise, post the claim using the payer's amount.

Important: read before using this information

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