Denial Code 295 (CO-295, PR-295) — Meaning & What to Do
Claim Adjustment Reason Code (CARC)
What denial code 295 means: The prior authorization on file doesn't match this claim.
What to do about denial code 295: Ask the provider's billing office to explain or correct this, and resubmit if needed.
CO-295 vs PR-295 vs OA-295: what the prefix means
| Code on your EOB | What the prefix means | Who typically pays |
|---|---|---|
| CO-295 | Contractual obligation — the provider writes the amount off | Usually not the patient |
| PR-295 | Patient responsibility | The patient |
| OA-295 | Other adjustment | Often another payer or plan |
The prefix tells you who is expected to absorb the amount; the number (295) tells you why.
Related codes
CARC 288A referral is required but was not provided.
CARC 273Coverage or program limits have been exceeded.
CARC 272Coverage/program guidelines weren't met.
CARC 256This service isn't payable under a managed-care contract.
Keep reviewing your bill
- Medical Bill vs EOB: What Is the Difference?
- How to Dispute a Medical Bill — Find Billing Errors Before You Pay
Frequently asked questions about Denial code 295
What does denial code 295 mean on my EOB?
The prior authorization on file doesn't match this claim.
What should I do about denial code 295?
Ask the provider's billing office to explain or correct this, and resubmit if needed.
Found this code on your bill or EOB?
Upload the document — MD Bill Check decodes every code, checks the math line by line, and explains what's worth questioning.