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Patient responsibilityCARC

PR-1 denial code

Deductible amount

The amount applied to the patient's annual deductible. Billable to the patient.

How to fix it

Bill the patient. Confirm the deductible was applied correctly against their accumulated year-to-date amount.

How to prevent it

Check real-time deductible status at eligibility verification so patients can be given accurate estimates and collected at the point of service.

In practice

A claim adjudicates with PR-1 — the amount applied to the patient's deductible. The plan is active, the service is covered, and nothing was denied. The patient simply has not yet met their annual deductible, so the allowed amount falls to them.

The practice receives no payment from the payer on this claim and bills the patient for the allowed amount.

The predictable difficulty is January, when deductibles reset. A patient accustomed to a small copayment suddenly owes the full allowed amount, and unless the practice checks deductible status and says so at check-in, that arrives as a surprise bill weeks later.

What sits behind it

PR-1 is not a denial and should never be worked as one. It is correct adjudication of a covered service against the patient's benefit design, and the only revenue cycle question is collection.

The volume of it has grown with high-deductible plan design, which has shifted a substantial share of revenue from payers to patients. Patient balances collect at materially lower rates than payer balances, and they get harder to collect the further they sit from the visit.

Deductible status is available in the eligibility response, which makes point-of-service collection possible rather than aspirational. Practices that check the remaining deductible and collect at check-in convert the hardest balance in the revenue cycle into the easiest.

Related codes

Terms used here — Patient Responsibility · Allowed Amount · Eligibility Verification

How we handle it — Patient Collections · Eligibility Verification · Patient Support

Primary sources

The rules behind PR-1, at the bodies that publish them.

  • Medicare Claims Processing Manual (opens in a new tab)

    Centers for Medicare & Medicaid ServicesThe operative manual for how Medicare claims must be coded, submitted, adjusted and appealed. When a payer policy and a vendor's advice disagree, this settles it.

  • No Surprises Act guidance (opens in a new tab)

    Centers for Medicare & Medicaid ServicesBalance billing restrictions, good faith estimates and the independent dispute resolution process — all of which change what a practice may bill a patient.

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Questions about PR-1

No. It is the allowed amount applied to the patient's deductible on a covered service. The plan is working as designed — the patient has not yet met their annual deductible, so the balance falls to them rather than the payer.

Because deductibles reset at the start of the plan year. A patient used to paying a small copayment suddenly owes the full allowed amount, and unless deductible status is checked and explained at check-in, it arrives as a surprise bill weeks later.

At the point of service. Deductible status is available in the eligibility response, so the remaining amount is knowable before the visit ends. Patient balances collect at materially lower rates the further they sit from the encounter.

They identify which part of the patient's cost share applies. PR-1 is the deductible, PR-2 is coinsurance, and PR-3 is the copayment. All three are patient responsibility on covered services rather than denials.

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