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Medicare Payment Reductions

E-Prescribing Penalty

Providers who receive the 2013 eRx payment adjustment will see the term “LE” on their Remittance Advice for all Medicare Part B services rendered January 1 – December 31, 2013. The remittance advice will also contain the following Claim Adjustment Reason Code (CARC) and Remittance Advice Remark Code (RARC):

CARC 237 – Legislated/Regulatory Penalty. At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT).

RARC N545 – Payment reduced based on status as an unsuccessful e-prescriber per the Electronic Prescribing (eRx) Incentive Program.

Sequestration Penalty

RARC 223 – Payment reduced based on sequestration.


CARC – Claim Adjustment Remark Code
RARC – Remittance Advice Remark Code