Official X12 description
“Only one visit or consultation per physician per day is covered.”
Source: X12 Claim Adjustment Reason Codes. The X12 External Code Lists are the single authoritative source for every CARC descriptor — always verify against the current release before building a claim-scrub rule.
What CARC B14 actually means
CARC B14 denies a second visit by the same physician on the same day — plan rule. If two visits were clinically necessary and distinct, appeal with encounter notes showing the medical need for separate encounters and appropriate modifier (25 or 27).
Common root causes
- Same-physician same-day visit limit hit.
Prevention checklist
- Same-day visit rules enforced at scheduling; modifier 25/27 used when clinically distinct.
Appeal strategy — step by step
Most CARC B14 denials clear faster with the right remediation than with a formal appeal. Work the steps in order and escalate only when a lower-effort path has been ruled out.
- 1Appeal with notes documenting medical necessity for each visit.
Sample appeal-letter language for CARC B14
Edit the bracketed fields before sending. This template is a starting point; a payer-specific appeal form may still be required — check the provider portal first.
Payer-specific notes
Payer-specific behavior for CARC B14 publishes here as the QuickIntell anonymized denial ETL ingests sufficient volume. In the meantime, consult the payer directory for the relevant provider manual and appeal form.
How common is CARC B14?
Out of 306 seeded CARCs, ranked by combined US monthly search volume for "CARC B14", "CO-B14 denial", and "denial code B14".
Platform frequency ranks publish once the anonymized denial-rate pipeline reaches the publication threshold (strategy §12 Phase 2).
How QuickRCM prevents CARC B14
QuickRCM catches the root causes above before the 837 leaves the clearinghouse:
- Claim-scrub rules fire on every root cause listed above — the scrub references the same X12 CAS segment logic that drives the denial, so what the payer checks, QuickRCM checks first.
- When a denial lands, QuickRCM routes it to the correct worker with the documentation bundle already attached (op note, LCD citation, modifier rationale, EOB, primary 835).
- Appeal templates tuned to each CARC (including this one) pull the supporting facts from the claim and fill the bracketed fields automatically.
CAQH CORE code combinations for CARC B14
Under the CAQH CORE Payment and Remittance Uniform Use rule, health plans may pair CARC B14 only with the remark codes and group codes below for the defined business scenario 3 (Billed service not covered by the health plan). A combination outside this list on an 835 is itself a payer compliance issue worth raising.
| RARC | Remark description | Group code | Scenario |
|---|---|---|---|
| (no RARC) | CARC used without a remark code | CO, PI or PR | 3 |
| M25 | The information furnished does not substantiate the need for this level of service. If you believe the service should have been fully covered as billed, or if you did not know and could not reasonably have been expected to know that we would not pay for this level of service, or if you notified the patient in writing in advance that we would not pay for this level of service and he/she agreed in writing to pay, ask us to review your claim within 120 days of the date of this notice. If you do not request an appeal, we will, upon application from the patient, reimburse him/her for the amount you have collected from him/her in excess of any deductible and coinsurance amounts. We will recover the reimbursement from you as an overpayment. | CO, PI or PR | 3 |
| M26 | The information furnished does not substantiate the need for this level of service. If you have collected any amount from the patient for this level of service /any amount that exceeds the limiting charge for the less extensive service, the law requires you to refund that amount to the patient within 30 days of receiving this notice. The requirements for refund are in 1824(I) of the Social Security Act and 42CFR411.408. The section specifies that physicians who knowingly and willfully fail to make appropriate refunds may be subject to civil monetary penalties and/or exclusion from the program. If you have any questions about this notice, please contact this office. | CO, PI or PR | 3 |
| M86 | Service denied because payment already made for same/similar procedure within set time frame. | CO, PI or PR | 3 |
| N2 | This allowance has been made in accordance with the most appropriate course of treatment provision of the plan. | CO, PI or PR | 3 |
| N628 | Out-patient follow up visits on the same date of service as a scheduled test or treatment is disallowed. | CO, PI or PR | 3 |
| N637 | Consultations are not allowed once treatment has been rendered by the same provider. | CO, PI or PR | 3 |
| N666 | Only one evaluation and management code at this service level is covered during the course of care. | CO, PI or PR | 3 |
Frequently asked questions — CARC B14
What does CARC B14 mean?
CARC B14 is an X12 Claim Adjustment Reason Code. The official definition is: "Only one visit or consultation per physician per day is covered." In plain English, the payer is telling you cARC B14 denies a second visit by the same physician on the same day — plan rule. If two visits were clinically necessary and distinct, appeal with encounter notes showing the medical need for separate encounters and appropriate modifier (25 or 27).
How do I resolve a CARC B14 (CO-B14) denial?
Start with the most common root cause: Same-physician same-day visit limit hit. First step: Appeal with notes documenting medical necessity for each visit. See the full remediation and appeal checklist on this page before filing a formal appeal.
Is CARC B14 patient responsibility?
No — CARC B14 is typically carried under CO (Contractual Obligation) or OA (Other Adjustment), which means it is the provider's responsibility, not the patient's. Do not bill the patient unless the 835 CAS group code is PR.
What does CARC B14 look like on an EOB or 835 remittance?
On the 835 ERA, CARC B14 appears in Loop 2110 CAS segment as "CAS*CO*B14*{amount}". On a paper EOB the same code prints in the Adjustment/Denial Reason column with the X12 description: "Only one visit or consultation per physician per day is covered." — usually paired with one or more RARC remark codes in the same remittance line for additional context.
Can CARC B14 be appealed successfully?
Yes — when the root cause does not apply to the specific claim. Overturn rates are strongest when the appeal cites the X12 definition, the payer's own published policy, and documentation that rebuts the payer's rationale. The sample appeal language block above is a starting point; always adapt it to the payer's reconsideration form.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. X12 code descriptors are maintained by the X12 External Code Lists; always verify against the current X12 release and the payer's own published policy before submitting or appealing a claim.