Non-covered / benefit depends on the RARC

Denial Code CARC 96: Non-covered charge(s)

CARC 96 means: non-covered charge(s). Here's what it means in plain English, why it happens, and how it's worked toward payment.

CARC 96 — Non-covered charge(s). Denial family: Non-covered / benefit.

Why you get a CARC 96 denial

The service isn't a covered benefit under the plan.
A RARC accompanies CARC 96 and explains the specific reason.
Sometimes a coding or benefit-verification issue rather than a true exclusion.

How to fix or appeal CARC 96

Read the paired RARC to learn the precise non-coverage reason.
Verify benefits and coding; correct and rebill if it's a coding/benefit-data issue.
If genuinely non-covered, follow the patient-responsibility / ABN protocol.

Recoverability depends on the RARC — sometimes a fixable coding/benefit issue, sometimes a true exclusion.

Have a stack of CARC 96 (or other) denials piling up? Get a free forensic A/R audit →

CARC 96 — FAQ

What does CARC 96 mean?

The charge is considered non-covered. The attached RARC is the key — it states whether it's a benefit exclusion, a coding issue, or something verifiable.

Is CARC 96 patient responsibility?

Sometimes — if it's a true non-covered benefit and the proper notice (e.g., ABN for Medicare) was given. First confirm it isn't a fixable coding or benefit-verification problem.