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N88 Remark Code: Conditional Payment, HHA Episode on File

N88 is an alert that the payer paid the service conditionally because a home health agency (HHA) episode of care notice is on file for the patient. If the patient was under that episode on the date of service, home health consolidated billing applies and the payment can be recouped.

Code: N88 (RARC N88)
Status: Active In use since January 1, 2000; last modified April 1, 2007.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): Any adjustment shown is a provider-side contractual amount. The alert itself does not move liability to the patient.
OA (Other Adjustment): Some payers report the conditional nature of the payment as an other adjustment; it signals a possible later recovery rather than a final denial.
Official description: Alert: This payment is being made conditionally. An HHA episode of care notice has been filed for this patient. When a patient is treated under a HHA episode of care, consolidated billing requires that certain therapy services and supplies, such as this, be included in the HHA's payment. This payment will need to be recouped from you if we establish that the patient is concurrently receiving treatment under a HHA episode of care.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N88 means

N88 appears on a paid line. The payer is telling you it found a home health agency episode notice for the patient and could not rule out overlap with your date of service. Under home health consolidated billing, certain therapy services and supplies furnished during an episode belong to the HHA’s bundled payment, not to an outside provider or supplier. Because the overlap is not yet confirmed, the payer released the money on a conditional basis.

The practical meaning is simple: this payment may not be final. If the payer later establishes that the patient was receiving care under the HHA episode, it can take the money back.

What to do

Post the payment as received, but flag the claim in your system as conditional so a later offset is not a surprise.
Check the patient’s home health status for the date of service through the payer’s eligibility tools or by asking the patient or referring physician.
If an episode was active, coordinate with the HHA. Services subject to consolidated billing are generally the agency’s responsibility, and any arrangement to furnish them under the agency’s payment is between you and the HHA.
If no episode was active, keep your documentation showing that, in case the payer later attempts a recovery you need to dispute.

For help reading payment alerts alongside their adjustment codes, see how CARC and RARC codes work together.

Codes that may appear with N88

CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): A routine fee-schedule adjustment on a paid line; N88 adds the warning that the payment itself is provisional.
CO-97 (The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.): If the payer later confirms the home health episode, the service may be treated as included in the HHA's payment.

N116 (Alert: This payment is being made conditionally because the service was provided in the home, and it is possible that the patient is under a home…): A similar conditional-payment alert used when the service was furnished in the home and a home health episode is only possible, not confirmed.
N70 (Consolidated billing and payment applies.): States outright that consolidated billing and payment apply, rather than warning that they might.
N120 (Payment is subject to home health prospective payment system partial episode payment adjustment.): Concerns the home health agency's own payment when an episode is cut short by transfer or discharge.

N88 FAQ

Do I need to refund the payment now?

No. N88 is a warning, not a recovery request. The payer will issue a separate demand or offset if it confirms the patient was in a home health episode on the service date.

How can I reduce the risk of recoupment?

Ask the patient or check eligibility for an open home health episode before furnishing therapy or supplies. If one exists, the HHA may need to furnish or arrange the service under its own payment.

Can I bill the patient if the payment is recouped?

Generally no. Services bundled into a home health episode are the agency's responsibility, so the recovered amount is usually settled with the HHA rather than billed to the patient.

Important: read before using this information

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