RARCM25ReferenceCurrentVerified Aug 15, 2026RARC M25
AR Guide explanation
What it means
The documentation submitted does not substantiate the need for the level of service billed.
AR Guide knowledge
Common denial category
AR Guide knowledge
Common usage
- Level-of-service (E/M) denials where the note does not justify the level billed
- Often accompanies CARC 50 medical-necessity denials
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.
Reference
Commonly paired CARCs
CARCs this remark commonly accompanies on the ERA/EOB, per the AR Guide pairing data.
CARC50These are non-covered services because this is not deemed a 'medical necessity' by the payer. Usage: Refer to the 835 Healthcare Policy Identification Segment (loop 2110 Service Payment Information REF), if present.CARC150Payer deems the information submitted does not support this level of service.CARC151Payment adjusted because the payer deems the information submitted does not support this many/frequency of services.
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