CARC213ReferenceCurrentVerified Aug 15, 2026CARC 213
AR Guide explanation
What it means
Non-compliance with the physician self-referral prohibition legislation or payer policy.
AR Guide knowledge
Common denial category
AR Guide knowledge
Common causes
- Stark law or self-referral concerns
- Referral relationship not documented
AR Guide knowledge
What AR should verify
- Review the referral arrangement for compliance
- Gather documentation of the referral relationship
AR Guide knowledge
Recommended action
- Appeal with compliance documentation if the arrangement is proper
- Correct the arrangement if non-compliant
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.