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N870 Remark Code: Cost Share Used Lower Billed Charge

N870 is an alert that the payer calculated the patient's cost sharing on your billed charge, not the qualifying payment amount (QPA), because your charge was the lower of the two. The No Surprises Act uses the lesser amount.

Quick facts

Code
N870 (RARC N870)
Status
Active In use since March 1, 2022.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • PR (Patient Responsibility): The patient's deductible, coinsurance, or copay, calculated from your billed charge. It is the most the patient owes for this protected service.
  • CO (Contractual Obligation): Any amount the plan did not pay that is not patient cost sharing. It cannot be balance billed for a service protected by the No Surprises Act.
Official description
Alert: In accordance with the No Surprises Act, cost sharing was based on the billed amount because the billed amount was lower than the qualifying payment amount.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N870 means

For emergency care and other services the No Surprises Act protects, the patient’s cost sharing is based on a recognized amount. Unless a specified state law or an All-Payer Model Agreement applies, that amount is the lesser of the qualifying payment amount (QPA) or your billed charge.

N870 says your billed charge won that comparison. The payer took your charge, applied the patient’s in-network deductible, coinsurance, or copay to it, and reported the result as patient responsibility.

This is purely an explanation of math. It is not a denial and it does not ask you to correct the claim.

What to do

  1. Bill the patient only the PR amount. It is the cap on what they owe for this service.
  2. Check the payment amount separately. The plan’s out-of-network payment to you is a different calculation. If it seems too low, the No Surprises Act open negotiation process is the route for disputing it.
  3. Watch for a pattern. Frequent N870 remarks on the same service suggest your charge for it sits below local contracted rates. Reviewing your fee schedule is a business decision, but the remark is a useful signal. An ERA analysis can surface how often it appears.

Codes that may appear with N870

  • PR-2 (Coinsurance Amount): Coinsurance calculated as a percentage of your billed charge rather than the QPA.
  • PR-1 (Deductible Amount): Deductible applied to the lower billed amount.
  • N869 (Alert: Cost sharing was calculated based on the qualifying payment amount, in accordance with the No Surprises Act.): The opposite outcome: the QPA was lower, so cost sharing was based on it.
  • N862 (Alert: Member cost share is in compliance with the No Surprises Act, and is calculated using the lesser of the QPA or billed charge.): A general alert that cost share used the lesser of the QPA or billed charge.
  • N867 (Alert: Cost sharing was calculated based on a specified state law, in accordance with the No Surprises Act.): Cost sharing came from a specified state law instead.

N870 FAQ

Why would my charge be lower than the QPA?

The QPA reflects the plan's median contracted rate for the service in your area. If your chargemaster price for that service is below that median, your charge becomes the lower figure.

Is N870 a sign my fees are too low?

It can be. If N870 shows up often for the same services, review those charges. Many plans pay based on the lesser of the charge or an allowed amount, so a low charge can cap what you receive.

Do I need to do anything when I see N870?

Usually not. Post the patient share as shown and review the plan's payment on its own merits.