N655Remark Code (RARC)Active
N655 Remark Code - Payment Based on Geographic Region
The N655 remark code indicates that the payment amount has been adjusted based on the provider's geographic region. This means the payer has applied a regional pricing policy that affects the reimbursement amount for the services rendered.
How It Relates to the Denial
The N655 remark code typically accompanies Claim Adjustment Reason Codes that reflect payment adjustments due to geographic considerations. The combination signals that the payment was influenced by location-based pricing policies.
Common Scenarios
1A provider submitted a claim for a surgical procedure performed in a rural area, and the remittance shows reduced payment with a reason code indicating a geographic adjustment.
→ The N655 remark code clarifies that the lower payment is a result of the provider's location, confirming that the adjustment is due to regional pricing.
2A claim for physical therapy services is denied for being above the usual and customary rates, with an accompanying reason code indicating a payment adjustment.
→ The N655 remark code suggests that the payment amount was modified based on the geographic region where the services were provided.
3A hospital submits a claim for outpatient services, and the payment received is less than expected, with a code indicating an adjustment for geographic pricing.
→ The presence of the N655 remark code indicates that the payment reduction is specifically tied to the provider's geographic area.
What to Do
- Verify that the payment amount aligns with the payer's geographic pricing policies.
- Check if the claim was submitted with the correct location information for the provider.
- Ensure that the billed service codes are appropriate for the geographic area indicated.
What to Check
- The payer's fee schedule for geographic adjustments.
- The claim submission details, including the provider's address.
- The accompanying Claim Adjustment Reason Code to understand the full context of the adjustment.