AGAR Guide
CARC96ReferenceCurrentVerified Aug 15, 2026

CARC 96

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.

Open denial workflow

AR Guide explanation

What it means

Non-covered charge(s). A remark code must accompany this code to explain the reason the charge is not covered.

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

  • Benefit exclusion applies
  • Service not covered under the patient's plan
  • Coverage limits exhausted

AR Guide knowledge

What AR should verify

  1. Read the accompanying remark code to identify the specific reason
  2. Review the benefit plan for the exclusion
  3. Check whether an advance beneficiary notice/waiver was obtained where applicable

AR Guide knowledge

Recommended action

  1. If the exclusion applies, bill the patient per plan rules
  2. If you believe the service should be covered, appeal with the applicable policy and documentation

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.