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Denial Code CARC 24: Charges are covered under a capitation agreement / managed care plan

CARC 24 means: charges are covered under a capitation agreement / managed care plan. Here's what it means in plain English, why it happens, and how it's worked toward payment.

Why you get a CARC 24 denial

• The patient is enrolled in a Medicare/Medicaid Advantage (managed care) plan, not traditional FFS.
• The claim went to the wrong entity (e.g., Medicare instead of the MA plan).
• A capitated service was billed fee-for-service.

How to fix or appeal CARC 24

1. Verify the patient's actual plan enrollment.
2. Bill the correct managed-care plan rather than the FFS payer.
3. Confirm whether the service is capitated before rebilling.

Recovered by routing the claim to the correct managed-care payer.

CARC 24 — FAQ

Why did I get CARC 24 from Medicare?

The patient is likely in a Medicare Advantage plan, so traditional Medicare isn't responsible. Identify the MA plan and bill it instead.

Is CARC 24 appealable?

It's typically a redirect, not an appeal — verify enrollment and submit to the correct plan.