What does denial code CO-24 mean?

Covered under a capitation or managed care agreement. The service is paid under a capitation arrangement, not per claim.

How do I fix a CO-24 denial?

Verify the patient's assigned provider or plan. No further billing if the capitation agreement covers it.

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Claim adjustment reason code · Contractual obligation

CO-24
Covered under a capitation or managed care agreement

What CO-24 means

The service is paid under a capitation arrangement, not per claim.

The CO group code means this amount is a contractual obligation: under most contracts you cannot bill it to the patient.

Common causes

Patient assigned to a capitated provider or plan

How to fix it

Verify the patient's assigned provider or plan
No further billing if the capitation agreement covers it

Check the remark code (RARC) that came with the denial and the payer's own policy, since rules vary by payer and plan. This is a plain-English summary written by GetMax; the official code text is published by X12 at x12.org/codes.

Prevent it next time

Most denials are caused before the claim is sent. See 12 ways to reduce claim denials, or let our denial management team work them for you.

Other codes

All denial codes →

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CO-24Covered under a capitation or managed care agreement