CARC119ReferenceCurrentVerified Aug 15, 2026CARC 119
AR Guide Workflow
Non-Covered Services
The service is not covered under the patient's benefit plan — an exclusion, a coverage limit, or a service the plan simply does not include.
AR Guide explanation
What it means
The benefit maximum for this time period or occurrence has been reached.
AR Guide knowledge
Common denial category
Non-Covered Services — The service is not covered under the patient's benefit plan — an exclusion, a coverage limit, or a service the plan simply does not include.
AR Guide knowledge
Common causes
- Annual or per-occurrence benefit limit exhausted
- Benefit tracked across multiple claims
AR Guide knowledge
What AR should verify
- Review the patient's benefit utilization for the period
- Confirm the benefit maximum and what counts toward it
AR Guide knowledge
Recommended action
- Bill the patient per plan rules once the benefit is exhausted
- If the utilization total is wrong, appeal with the benefit history
About this guidance: Note
AR Guide knowledge is general reference content written by our team — it is not payer-specific policy and never replaces the payer’s documentation or your contract. Always confirm specifics with the payer.