Look up another code

N887 Remark Code: Non-Contracted MA Provider Appeal

N887 tells a provider that does not participate with a Medicare Advantage plan that it may appeal a full or partial denial, or a payment below the expected Medicare rate. The appeal must be in writing, filed within the timeframe in the remark, and include a signed Waiver of Liability Statement.

Code: N887 (RARC N887)
Status: Active In use since July 1, 2023.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: CO (Contractual Obligation): The denied or reduced amount the provider is disputing. For a non-contracted provider, the waiver means the patient will not be billed for it if the appeal fails.
PR (Patient Responsibility): Patient cost sharing under the Medicare Advantage plan, which is not the subject of the provider's appeal.
Official description: Providers not participating in the Medicare Advantage Plan have the right to appeal if the plan has partially or fully denied payment or if the provider believes the plan has not paid the services at the expected Medicare reimbursable rate or type of level/service. Providers may file their appeal in writing within 60 calendar days after the date of the remittance advice. For the plan to review the appeal, the plan will need a completed signed Waiver of Liability Statement. To obtain a Waiver of Liability form, please contact your Medicare Advantage Plan. Once we receive the completed forms, we will give you a decision on your appeal within 60 calendar days.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N887 means

Providers without a contract with a Medicare Advantage plan are generally paid what Original Medicare would pay for covered services. When they disagree with a plan’s decision, they have a formal appeal right. N887 spells out that right on the remittance.

According to the remark, the appeal:

Can challenge a full or partial denial, or a payment below the expected Medicare rate or level of service.
Must be filed in writing within the window stated in the remark, counted from the remittance date.
Needs a completed, signed Waiver of Liability Statement before the plan will review it.

The plan then issues a decision within the timeframe the remark describes.

Common reasons non-contracted providers appeal

A medical necessity or coverage denial they believe is wrong.
Payment below the Original Medicare fee schedule amount for the service and location.
A level-of-service downgrade.

What to do

Calendar the deadline from the remittance date immediately.
Get the waiver form from the plan and have an authorized person sign it.
Write the appeal, explaining the issue and attaching records, the remittance, and your Medicare rate calculation for payment disputes.
Send everything together to the plan’s appeals address and keep proof of delivery.
Do not bill the patient for the disputed amount; the signed waiver prohibits it.

Codes that may appear with N887

CO-50 (These are non-covered services because this is not deemed a 'medical necessity' by the payer.): A medical necessity denial that a non-contracted provider can appeal.
CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): A payment reduction you may dispute if it falls below the Medicare rate you expected.

MA01 (Alert: If you do not agree with what we approved for these services, you may appeal our decision.): The Original Medicare appeal-rights alert used on fee-for-service remittances.
N1 (Alert: You may appeal this decision in writing within the required time limits following receipt of this notice by following the instructions…): A general alert that you may appeal in writing under your contract, plan documents, or statute.
N210 (Alert: You may appeal this decision.): A short alert that the decision can be appealed.

N887 FAQ

What is a Waiver of Liability Statement?

It is a form in which the non-contracted provider agrees not to bill the enrollee for the disputed services, whatever the outcome of the appeal. Medicare Advantage plans require it before they review a non-contracted provider's appeal.

Where do I get the form?

The remark says to contact the Medicare Advantage plan. Plans commonly also post it on their provider websites.

Does N887 apply to contracted providers?

No. Contracted providers follow the dispute process in their agreement with the plan.

Important: read before using this information

This page is general educational information about a standard industry code set. It is not medical billing, coding, legal, reimbursement, or compliance advice, and it does not create a professional or advisory relationship with ClaimsRevenue.

Code definitions, payer usage, contracts, and laws change, and payers may apply the same code differently. The information is provided “as is,” without warranties of any kind, express or implied, including accuracy, completeness, or currency. You are solely responsible for verifying it against the current official X12 code lists, CMS guidance, your payer contracts, and payer policies before relying on it, and for every billing, coding, collection, and appeal decision you make.

Using this information does not guarantee that any claim will be paid or that any appeal will succeed. To the fullest extent permitted by law, ClaimsRevenue and MOODRX LLC are not liable for any loss or damage arising from its use. Official code descriptions are published by X12 and are quoted for reference only. See our full Claims Validation Disclaimer.