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N876 Remark Code: NSA Notice of Denial of Payment

N876 is an alert that the service is covered, but the plan is making no payment, and this remittance serves as the No Surprises Act notice of denial of payment. You may start open negotiation if you want a higher out-of-network rate than what the patient paid in cost sharing.

Quick facts

Code
N876 (RARC N876)
Status
Active In use since March 1, 2022.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • PR (Patient Responsibility): Patient cost sharing, typically the deductible, that used up the recognized amount so the plan owed nothing.
  • CO (Contractual Obligation): Your charge above the recognized amount. It cannot be balance billed for a protected service.
Official description
Alert: This item or service is covered under the plan. This is a notice of denial of payment provided in accordance with the No Surprises Act. The provider or facility may initiate open negotiation if they desire to negotiate a higher out-of-network rate than the amount paid by the patient in cost sharing.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N876 means

The No Surprises Act requires a plan to respond to a clean claim for a protected out-of-network service with either an initial payment or a notice of denial of payment. N876 is that notice.

The wording is easy to misread. It does not mean the claim was denied for coverage reasons. It confirms the service is covered, but the plan’s payment to you is zero. The typical cause is a patient who has not met the deductible, so the whole recognized amount was assigned to them as cost sharing.

The remark also reminds you that you can open negotiation with the plan if you want more than what the patient’s share covers.

What to do

  1. Collect the PR amount from the patient, and nothing more.
  2. Decide whether to negotiate. Compare the patient’s share with what you consider a fair out-of-network rate for the service.
  3. Start open negotiation promptly if you proceed. The federal window begins with this notice and is short, so calendar it the day the remittance posts.
  4. Keep a copy of the remittance. It is the document that starts the clock and the evidence you will need if the dispute moves to federal IDR.

Codes that may appear with N876

  • PR-1 (Deductible Amount): The most common reason: the full recognized amount went to the patient's deductible.
  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge above the amount the plan recognized.
  • N877 (Alert: This initial payment is provided in accordance with the No Surprises Act.): The plan did make an initial payment, rather than a notice of denial.
  • N874 (Alert: This final payment was determined through open negotiation, in accordance with the No Surprises Act.): Marks the final payment if open negotiation leads to agreement.
  • N885 (Alert: This claim was not processed in accordance with the No Surprises Act cost-sharing or out-of-network payment requirements.): Different situation: the plan disputes that the No Surprises Act applies at all.

N876 FAQ

Is N876 a coverage denial?

No. The remark says the service is covered. The plan paid nothing because the patient's cost sharing covered the full recognized amount, or for another payment reason, and the law calls that a notice of denial of payment.

Why would I negotiate if the plan owes nothing?

Negotiation is about the total out-of-network rate. If you believe the service is worth more than the patient's cost sharing, you can seek an additional payment from the plan.

Can I bill the patient the difference?

No. For protected services the patient owes only the PR amount on the remittance.