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N891 Remark Code: Primary Already Paid the Maximum

N891 means the primary insurance already paid at least the maximum this payer allows for the service or procedure, so no further payment is due from this payer. It is common on secondary claims when the primary's payment exceeds the secondary's allowance.

Quick facts

Code
N891 (RARC N891)
Status
Active In use since November 1, 2023.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • OA (Other Adjustment): The impact of the prior payer's adjudication. The amount reflects what the primary paid and is not billable to the patient by this payer's reckoning.
  • CO (Contractual Obligation): A write-off where this payer's allowance, already covered by the primary, is lower than your charge.
Official description
The maximum allowable payment for this service/procedure was paid by the primary insurance. No further payment due.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N891 means

When a patient has two plans, the secondary payer looks at what the primary paid before deciding its own share. Many secondary payers use a “lesser of” or allowance-based method: they will never pay more in total than their own maximum allowable amount for the service.

N891 means the primary’s payment already reached or exceeded that maximum. From the secondary’s perspective, the service is fully paid, so it owes nothing more.

Common causes

  • The primary plan has a higher fee schedule than the secondary.
  • The secondary is Medicaid, which usually limits total payment to its own rate.
  • The secondary plan’s coordination method does not cover the primary’s cost sharing.

What to do

  1. Verify the primary payment reported to the secondary matches the primary’s remittance.
  2. Check the secondary’s allowance for the service. If it is wrong, request reprocessing.
  3. Decide on the remaining balance based on contracts and program rules. Do not bill a Medicaid or QMB patient for balances their coverage protects.
  4. Close the secondary claim when the numbers are correct.

How to prevent surprises

Know each secondary payer’s coordination method before you bill. See eligibility and COB denials for common coordination problems.

Codes that may appear with N891

  • OA-23 (The impact of prior payer(s) adjudication including payments and/or adjustments. (Use only with Group Code OA)): The impact of prior payer adjudication, the usual partner for N891 on secondary claims.
  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): The charge exceeded this payer's maximum allowable amount.
  • N4 (Missing/Incomplete/Invalid prior Insurance Carrier(s)): The secondary could not process the claim because the prior payer EOB was missing.
  • N765 (This payer does not cover coinsurance assessed by a previous payer.): This payer does not cover coinsurance assessed by the previous payer.
  • N766 (This payer does not cover co-payment assessed by a previous payer.): This payer does not cover a copay assessed by the previous payer.
  • PR-275 (Prior payer's (or payers') patient responsibility (deductible, coinsurance, co-payment) not covered. (Use only with Group Code PR)): Prior payer's patient responsibility is not covered.

N891 FAQ

Can I bill the patient the remaining balance?

It depends on the primary payer's terms, your contracts, and program rules. If the primary assigned patient responsibility and your contract with the primary allows collection, that amount may be billable; Medicaid and some secondary contracts restrict this.

Why did the secondary pay nothing even though the patient had a deductible?

Many secondary payers pay only up to their own allowance. If the primary's payment already reaches that allowance, the secondary's calculation leaves nothing to pay.

Is N891 worth appealing?

Only if you believe the secondary used the wrong allowance or misread the primary's payment.