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N914 Remark Code: Priced Under California AB-72

N914 means the payer priced and processed the claim under California Assembly Bill 72 (AB-72). That law covers certain non-emergency services by out-of-network professionals at in-network facilities for plans it applies to, limits patient cost sharing, and sets how the plan pays the provider.

Quick facts

Code
N914 (RARC N914)
Status
Active In use since July 1, 2025.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): Your charge above the AB-72 payment. For services the law protects, it generally cannot be balance billed.
  • PR (Patient Responsibility): In-network-level cost sharing, which AB-72 caps for protected services.
Official description
This claim was priced and processed in accordance with California AB-72 Health care coverage.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What N914 means

California passed AB-72 before the federal No Surprises Act to protect patients who get care at an in-network facility from a professional who is not in their network. For state-regulated plans, the patient pays only in-network cost sharing, and the plan pays the provider according to the law’s payment standard.

N914 tells you the payer treated your claim as one of those cases. It identifies the legal basis for the pricing, which also tells you which dispute route applies.

Common scenarios

  • An out-of-network anesthesiologist, radiologist, or other professional at an in-network hospital or surgery center.
  • A non-emergency service where the patient had no real choice of provider.

What to do

  1. Confirm the plan is state-regulated. AB-72 does not govern self-funded employer plans.
  2. Check the payment against the AB-72 formula for the service and region.
  3. Bill the patient only the PR amount. Balance billing is generally prohibited for protected services.
  4. Use the plan’s dispute process first, then California’s independent dispute resolution process if needed, following state deadlines.
  5. Track AB-72 claims separately so you can see which plans and facilities generate them.

Codes that may appear with N914

  • CO-45 (Charge exceeds fee schedule/maximum allowable or contracted/legislated fee arrangement.): Reduction to the rate determined under AB-72.
  • PR-2 (Coinsurance Amount): Coinsurance at the in-network level.
  • N883 (Alert: Processed according to state law): A general alert that state law applied, without naming the law.
  • N871 (Alert: This initial payment was calculated based on a specified state law, in accordance with the No Surprises Act.): An initial No Surprises Act payment calculated under a specified state law.
  • N830 (Alert: The charge[s] for this service was processed in accordance with Federal/ State, Balance Billing/ No Surprise Billing regulations.): The service was processed under federal or state balance billing rules.

N914 FAQ

How does AB-72 set the payment?

In general, the plan pays the greater of its average contracted rate or 125% of the Medicare amount for the service in the area, unless the parties agree otherwise. Check current California guidance for details.

Can I dispute the rate?

California has an independent dispute resolution process for AB-72 claims, run through the state regulators. Check the plan's dispute process and state requirements before filing.

Does AB-72 apply to every plan?

No. It applies to plans regulated by California, such as those overseen by the Department of Managed Health Care or the Department of Insurance, not to self-funded ERISA plans.