US · guidance

CMS Pub. 100-04, ch. 17, § 100.4.3

Submission of Claims from Vendors With the J1 No Pay

activein force · 2026-08-25 – presentas-observed

Modifier

(Rev. 3721, Issued: 02-24-17, Effective: 05-25-17, Implementation: 05-25-17)

The designated A/B MAC (B) shall treat as unprocessable claims submitted by vendors

with a no-pay modifier, 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 Two

Group Code: CO

CARC: 16

RARC: N265

MSN: 9.7 and 17.11

History

(Rev. 3721, Issued: 02-24-17, Effective: 05-25-17, Implementation: 05-25-17)

Provenance

Source: cms.gov
Retrieved: 2026-08-25
Edition: iom-2026-08-25
Content hash: 625094f2aaa3dfe14abdaf4692b6d950ac02b93fc9bd7cb10367fb7aa4c94698

View the official source →

The link goes to the issuing authority’s own document — the one we read to produce this record. Where a source publishes whole titles rather than sections, your browser may need a moment to jump to the provision.

Unofficial copy of government-published law, reproduced from official sources with full provenance. Not an official publication; verify against official sources before relying on it in a filing. Records in the 'guidance' corpus, and only that corpus, are sub-regulatory (interpretive guidelines, survey procedures) and are not binding law. Validity bounds follow each jurisdiction's declared temporalBasis.

Coverage · API docs