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Denial Code P25

CARC P25: Payment adjusted based on Medical Provider Network

This is a Claim Adjustment Reason Code (CARC). CARCs explain why a payer adjusted or denied a claim line and appear with a group code (CO, PR, OA, PI). Codes appear on the EOB / ERA after a claim is adjudicated.

Reference only — CARC/RARC are national code sets updated periodically. Verify against the current official list before acting on a denial or appeal.

Related CARC codes

P22
Payment adjusted based on the Medical Payments Coverage and/or Personal Injury Protection …
P23
Medical Payments Coverage or Personal Injury Protection Benefits jurisdictional fee schedu…
P24
Payment adjusted based on Preferred Provider Organization
P26
Payment adjusted based on Voluntary Provider network
P27
Payment denied based on the Liability Coverage Benefits jurisdictional regulations and/or …
P28
Payment adjusted based on the Liability Coverage Benefits jurisdictional regulations and/o…

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