Brief Case

Treas. Reg. § 54.9816-6A

Use of claim adjustment reason codes and remittance advice remark codes.
eCFR amendment effective 2026-08-03 · current · last amended by T.D. 10049, 91 FR 34047, June 4, 2026
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(a) In general. When providing any remittance advice (including in paper or electronic form) to an entity (other than a participant, beneficiary, or enrollee) that does not have a contractual relationship, directly or indirectly, with a group health plan or a health insurance issuer offering group or individual health insurance coverage for the furnishing of an item or service under the plan or coverage, in response to a claim for payment for health care items and services furnished by that entity, the plan or issuer must use claim adjustment reason codes (CARCs) and remittance advice remark codes (RARCs) (as those terms are described in standards and operating rules adopted at 45 CFR part 162) in the manner and timeframe specified in guidance issued by the Secretaries of the Treasury, Labor, and Health and Human Services, or as required under any applicable adopted standards and operating rules under 45 CFR part 162, to communicate information related to whether the claim is or is not subject to the provisions of this part and 45 CFR 149 subparts E and F.
(b) Severability
(1) Any provision of this section held to be invalid or unenforceable by its terms, or as applied to any person or circumstance, will be construed so as to continue to give maximum effect to the provision permitted by law, unless such holding is one of utter invalidity or unenforceability, in which event the provision will be severable from this section and will not affect the remainder thereof or the application of the provision to persons not similarly situated or to dissimilar circumstances.
(2) The provisions in this section are intended to be severable from the provisions in §§ 54.9816-6, 54.9816-8, and 54.9816-9, from any grant of forbearance from removal resulting from this subpart, and from any provision referenced in §§ 54.9816-6, 54.9816-8, and 54.9816-9.
Source credit, amendments & notes

[T.D. 10049, 91 FR 34047, June 4, 2026]

Treas. Reg. § 54.9816-6A — Use of claim adjustment reason codes and remittance advice remark codes. · eCFR amendment effective 2026-08-03 · https://pensionresource.website/EAMain?content=EAMain.Law&id=cfr26-54.9816-6A&asof=2026-08-03 · printed Oct 16, 2026
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  • (a) In general.
  • (b) Severability
Cited by (code & regs)
Guidance addressing this section

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Also cited in 2 other documents
IRS / Treasury
Final Rules
  • 91 FR 33900 Jun 4, 2026 — Federal Independent Dispute Resolution Operations
Proposed Rules
  • 88 FR 75744Proposed Nov 3, 2023 — Federal Independent Dispute Resolution Operations Comments due Jan 2, 2024

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Each row is a version of the text as published by the official source. Code dates are the edition/release point that first reflected the change; regulation dates are eCFR effective dates. The library checks the official sources automatically, so new versions appear here on their own; “run” opens the sync that recorded a version.

EffectiveThroughSourceAmended by
Jun 4, 2026Aug 2, 2026eCFR amendment effective 2026-06-04 run 6View
Aug 3, 2026currenteCFR amendment effective 2026-08-03 run 6T.D. 10049, 91 FR 34047, June 4, 2026View · Redline (sign in)
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