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PR-142 Denial Code: Monthly Medicaid Patient Liability

PR-142 reports the monthly Medicaid patient liability amount. Some Medicaid recipients, commonly those in nursing facilities or with a share of cost, must contribute a set amount of their income toward care each month, and the payer deducts that amount from its payment.

Quick facts

Code
PR-142 (CARC 142)
Status
Active In use since June 30, 2000; last modified September 30, 2007.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • PR (Patient Responsibility): The usual group in practice. The patient liability is owed by the Medicaid recipient and is collected from them or their representative.
  • CO (Contractual Obligation): Reported by some payers under CO. Even so, the amount usually reflects the recipient's required contribution; confirm with the state Medicaid program how to collect it.
Official description
Monthly Medicaid patient liability amount.
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What PR-142 means

CARC 142 is the monthly Medicaid patient liability amount. In some Medicaid programs, a recipient with income above a certain level must contribute part of it toward their care each month. The state determines that amount. When the provider bills Medicaid, the payer subtracts the patient liability and pays the balance.

This most often applies to long-term care, where nursing facility residents contribute most of their monthly income, and to share-of-cost programs. The remittance uses CARC 142 to show how much of the claim the recipient owes.

Example: a nursing facility bills a month of care for a Medicaid resident. The state’s record shows a monthly patient liability. The remittance deducts that amount with CARC 142 and pays the rest; the facility collects the liability from the resident.

Common causes

  • A recipient in a nursing facility or waiver program with a state-determined monthly contribution.
  • A share-of-cost Medicaid recipient whose contribution applies to the month’s services.
  • A change in the recipient’s income, which changes the liability for a given month.
  • A patient liability amount on the claim that differs from the state’s record.
  • The liability applied to the wrong month or split incorrectly across claims.

How to fix it

  1. Confirm the liability for the month of service in the state’s eligibility system or the recipient’s notice.
  2. Post the amount to the resident’s or patient’s account, not to a write-off, regardless of whether the payer labeled it CO or PR, unless the state tells you otherwise.
  3. If the amount on the claim was wrong, correct it and send a corrected claim per your state Medicaid program’s rules.
  4. If the state’s record is outdated, work with the recipient or their caseworker to update it, then ask for reprocessing.
  5. Collect from the recipient or representative according to your admission agreement and state rules.

How to prevent problems with PR-142

  • Check each Medicaid resident’s monthly liability before billing and whenever income changes.
  • Keep patient liability amounts in your billing system by month.
  • Reconcile collected patient liability with remittance amounts monthly.
  • Monitor for liability mismatches with an ERA Analyzer. For eligibility steps, see eligibility and COB denials.

Specialty notes

Nursing facilities and long-term care providers are the main audience. Home and community-based service providers in states with share-of-cost waiver programs may also see it.

Remark codes that may appear with PR-142

  • N58 (Missing/incomplete/invalid patient liability amount.): The patient liability amount on the claim is missing, incomplete, or invalid.
  • N861 (Alert: Mismatch between the submitted Patient Liability/Share of Cost and the amount on record for this recipient.): The patient liability or share of cost on the claim does not match the amount on record for the recipient.
  • CO-178 (Patient has not met the required spend down requirements.): The patient has not met the required spend down requirements for Medicaid eligibility.
  • PR-1 / PR-2 / PR-3 (Deductible, coinsurance, and co-payment amounts.): Standard cost-sharing, which works differently from Medicaid patient liability.
  • OA-23 (The impact of prior payer(s) adjudication including payments and/or adjustments. (Use only with Group Code OA)): Impact of prior payer adjudication on Medicaid's payment.

PR-142 FAQ

What is Medicaid patient liability?

The amount of a recipient's monthly income that the state requires them to contribute toward the cost of care, often called patient pay or share of cost. The state calculates it, and Medicaid pays the rest.

Who collects the patient liability?

The provider, typically a nursing facility, collects it from the resident or their representative. Medicaid reduces its payment by that amount.

What if the liability on the remittance is wrong?

Check the amount on the state's eligibility system or notice for that month. If the claim or the payer used the wrong amount, correct the claim or ask the state program to update its record.