US · guidance
CMS Pub. 100-04, ch. 1, § 10.1.9.4
An A/B MAC (B) Receives a Claim for an RRB Beneficiary
When a local contractor (Part B MAC or carrier) receives a Form CMS-1500 or
electronic claim that is identified as a RRB claim for Medicare payment that should be
processed by the RRB contractor, the claim shall be returned as unprocessable.
The contractor shall use the following remittance advice messages and associated codes
when rejecting/denying claims under this policy. This CARC/RARC combination is
compliant with CAQH CORE Business Scenario Three.
Group Code: CO
CARC: 109
RARC: N105
MSN: N/A
NOTE: CMS requests that when RRB receives a claim that is not for an RRB
beneficiary that they return the claim to the sender and notify them that the claim must be
submitted to the local contractor (Part B MAC or carrier) or DME MAC for processing.
History
(Rev. 3510, Issued: 04-29-16, Effective: 10-01-16, Implementation; 10-03-16)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
fb1ee00d47cf9402c367c5dc36830c847595782074fd1c0b0bc1a4aef6fb3ba1
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