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N872 Remark Code: Final Payment Under State Law

N872 is an alert that the final out-of-network payment on this claim was calculated under a specified state law, in line with the No Surprises Act. It typically signals the end of the state-law payment process for the claim.

Quick facts

Code
N872 (RARC N872)
Status
Active In use since March 1, 2022.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The remaining difference between your billed charge and the final state-law amount. It is not collectible from the patient.
  • PR (Patient Responsibility): The patient's in-network-level cost sharing, which does not change because the payment was finalized.
Official description
Alert: This final payment was calculated based on a specified state law, in accordance with the No Surprises Act.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N872 means

Under the No Surprises Act, states with their own surprise-billing laws keep control of how out-of-network rates are settled for the plans they regulate. When a plan finishes that state-governed process, it can mark the payment with N872.

The key word is final. Where N871 flags a starting payment, N872 tells you the amount now reflects the settled out-of-network rate for this claim under state rules. Depending on the state, that rate might come from a statutory formula, a benchmark database, or an arbitration decision.

What to do

  1. Match the payment to the determination. If a state arbitration or review produced the rate, compare the paid amount with the written decision. Any shortfall is a payment error to raise with the plan.
  2. Post the adjustment. Write off the CO balance once the numbers agree, and record the claim as closed in your out-of-network dispute log.
  3. Keep patient billing to the PR amount. Finalizing the provider payment does not change what the patient owes.
  4. Get specific advice before contesting. Whether any further challenge is possible depends on the state statute and plan type.

Codes that may appear with N872

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): Reports the amount of your charge above the final state-law rate.
  • PR-2 (Coinsurance Amount): Coinsurance the patient owes on the protected service.
  • N871 (Alert: This initial payment was calculated based on a specified state law, in accordance with the No Surprises Act.): The earlier step: the initial payment was calculated under a specified state law.
  • N873 (Alert: This final payment was calculated based on an All-Payer Model Agreement, in accordance with the No Surprises Act.): A final payment set by an All-Payer Model Agreement instead of state law.
  • N875 (Alert: This final payment equals the amount selected as the out-of-network rate by a Federal Independent Dispute Resolution Entity, in accordance…): A final payment chosen by a federal independent dispute resolution entity.
  • N858 (Alert: State regulations relating to an Out of Network Medical Emergency Care Act were applied to the processing of this claim.): An alert that state out-of-network emergency care regulations were applied.

N872 FAQ

How is N872 different from N871?

N871 labels the first payment calculated under state law. N872 labels the final one, for example after the state's process has run or when the state formula produced the settled rate.

Can I still dispute a final payment?

Options are limited once a payment is final, and they depend on the state. Check with the state regulator or your counsel before taking further action.

Should I write off the CO balance?

In most cases yes, once you confirm the payment matches the state determination. The patient cannot be billed for it.