MedicaidAdministrativeMedium impact
Implementation of ACA 1104 Uniform Use of CARCs, RARCs and CAGCs on the X12 835 Health Care Claim Payment/Advice
Connecticut Medicaid (HUSKY Health)·CT·Reimbursement
We identified it
Jun 20, 2026
Summary
Connecticut Medicaid (HUSKY Health) is implementing standardized use of Claim Adjustment Reason Codes (CARCs), Remittance Advice Remark Codes (RARCs), and Claim Adjustment Group Codes (CAGCs) on electronic remittance advices (X12 835 transactions). This will standardize how denial and adjustment reasons are communicated to providers on their payment reports.
Action Required
Billing team should review updated X12 835 remittance advice reports from Connecticut Medicaid to understand new standardized reason codes for claim denials and adjustments. Update denial tracking processes to accommodate the new uniform CARC, RARC, and CAGC coding system. Train staff on interpreting the standardized codes for more efficient claim resolution.