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N935 Remark Code: Patient No Longer Medicaid/QMB

N935 is an alert that the patient is no longer a Medicaid recipient or Qualified Medicare Beneficiary (QMB). Protections and secondary coverage tied to that status may no longer apply for the dates of service, which can change how you bill cost sharing.

Code: N935 (RARC N935)
Status: Active In use since July 1, 2026.
Code set: Remittance Advice Remark Codes (RARC)
Group codes: PR (Patient Responsibility): Deductible, coinsurance, or copay amounts. With QMB or Medicaid status ended, they may now be billable to the patient or another payer, depending on the dates.
Official description: Alert: Patient is no longer a Medicaid/Qualified Medicare Beneficiary.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified: September 24, 2026 against the official X12 list.

What N935 means

Qualified Medicare Beneficiaries are protected from being billed for Medicare deductibles, coinsurance, and copays, and Medicaid often picks up those amounts as secondary. N935 tells you that status has ended according to the payer’s records.

The alert is a prompt to review. It does not itself adjust anything.

What to do

Check the end date in the state eligibility system or through the patient.
Stop crossover billing to Medicaid for dates after coverage ended.
Update patient financial information and, for later dates of service, bill cost sharing according to your policies.
Protect earlier dates. Do not bill the patient for cost sharing on services provided while they were still a QMB.
Point the patient to reapplication if they may still qualify. If coverage is restored retroactively, rebill the secondary payer and refund any patient payments as needed. See eligibility and COB denials.

Codes that may appear with N935

PR-1 / PR-2 (Deductible and coinsurance amounts.): Cost sharing that may no longer be protected from patient billing.

N192 (Alert: Patient is a Medicaid/Qualified Medicare Beneficiary.): The opposite alert: the patient is a Medicaid or Qualified Medicare Beneficiary.
N781 (Alert: Patient is a Medicaid/ Qualified Medicare Beneficiary.): The patient is Medicaid/QMB; review for wrongly collected deductible.
N782 (Alert: Patient is a Medicaid/ Qualified Medicare Beneficiary.): The patient is Medicaid/QMB; review for wrongly collected coinsurance.

N935 FAQ

Can I bill the patient for Medicare cost sharing now?

Only for dates of service after QMB and Medicaid coverage ended. Confirm the exact end date first. QMB billing protections still apply to services while the patient held that status.

Why did the status end?

Common reasons are a missed renewal, a change in income or assets, or a move. Patients can sometimes regain coverage, occasionally retroactively.

Should I tell the patient?

Yes. The patient may not know their coverage lapsed and may be able to reapply through their state Medicaid agency.

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