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PR-187 Code: HSA, FSA or HRA Spending Account Payment

CARC 187 reports that part of the claim was paid from a consumer spending account, such as a Flexible Spending Account, Health Savings Account, or Health Reimbursement Account. It is informational, not a denial, and reduces what the patient still owes.

Quick facts

Code
PR-187 (CARC 187)
Status
Active In use since June 30, 2005; last modified January 25, 2009.
Code set
Claim Adjustment Reason Codes (CARC)
Group codes
  • PR (Patient Responsibility): The most common use. The amount was the patient's responsibility and was paid from the patient's spending account.
  • CO (Contractual Obligation): Less typical. The payer uses the contractual group to report the spending account payment. Read it as a payment source, not a write-off.
  • OA (Other Adjustment): Some payers report it under Other Adjustments. Either way, it identifies spending account money applied to the claim.
Official description
Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.)
X12 Claim Adjustment Reason Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What CARC 187 means

CARC 187 reads “Consumer Spending Account payments (includes but is not limited to Flexible Spending Account, Health Savings Account, Health Reimbursement Account, etc.).” Some payers administer both the health plan and the member’s spending account, and they can pay the patient’s share directly from that account when processing the claim. CARC 187 reports that amount.

The slug for this page uses the CO prefix, but in practice the code most often appears with PR, since it is paying down what the patient owes.

Example: a visit has an allowed amount of $150. The plan pays $100 and assigns $50 coinsurance. The payer automatically pays $50 from the patient’s HRA and reports it with CARC 187 and remark N520. The patient owes nothing further.

When CARC 187 needs attention

  • Posting rules treat it as a write-off, which understates patient payments and can lead to incorrect balances.
  • The patient is billed for an amount the spending account already paid.
  • Partial payments leave a remaining patient balance that is not billed.
  • Funds are later reversed, for example if an HSA or FSA claim is disputed.
  • The patient also paid at check-in, creating a credit balance that needs a refund.

How to handle it

  1. Identify the spending account amount on the ERA line with CARC 187.
  2. Post it as a payment from the account (a separate payment type is helpful for reporting).
  3. Recalculate the patient balance after the plan payment, spending account payment, and any other adjustments.
  4. Bill the patient only for what remains under PR.
  5. Refund the patient if they already paid at the visit for an amount the account also covered.

How to prevent posting errors

  • Map CARC 187 in your posting logic as a payment, not an adjustment.
  • Collect estimated cost-sharing carefully at the visit for patients whose plan pays from spending accounts automatically, to avoid double collection.
  • Reconcile patient balances after ERA posting. ERA Analyzer breaks down each adjustment on the remittance so account payments aren’t confused with write-offs.
  • Read more on remittance codes in CARC and RARC analysis.

Remark codes that may appear with PR-187

  • N520 (Alert: Payment made from a Consumer Spending Account.): Confirms the payment came from a consumer spending account.
  • N367 (Alert: The claim information has been forwarded to a Consumer Spending Account processor for review; for example, flexible spending account or…): The claim was forwarded to a spending account processor for review.
  • N740 (The member's Consumer Spending Account does not contain sufficient funds to cover the member's liability for this claim/service.): The account didn't have enough funds to cover the member's full liability.
  • PR-1 / PR-2 / PR-3 (Deductible, coinsurance, and co-payment amounts.): The patient cost-sharing that spending account funds are typically applied to.
  • 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, another way payments from other sources are reported.

PR-187 FAQ

Is PR-187 a denial?

No. It tells you money from the patient's spending account was applied. The patient's balance should be reduced by that amount.

How should I post CARC 187?

Post it as a payment from the patient's spending account (or as a patient payment, depending on your system), not as a contractual write-off. Then bill the patient only for any remaining responsibility.

What if the account didn't cover everything?

Remark codes like N740 indicate insufficient funds. The unpaid portion of the patient's cost-sharing remains billable to the patient under PR.

Why did the payer pay from the account without asking me?

Some plans automatically forward the member's cost-sharing to the linked spending account when the patient has elected that option. The patient controls that setting with their plan or account administrator.