What does CARC 170 mean?

CARC 170 means "Payment is denied when performed/billed by this type of provider.". The recommended action is: Verify correct provider type is billing; resubmit under correct provider if applicable.

How do I resolve CARC 170?

Verify the rendering or referring provider's enrollment status with this payer Check that the provider's NPI, taxonomy, and license are current and active If the provider is not enrolled, initiate enrollment before resubmitting Obtain a re-referral or re-order from an enrolled, eligible provider if needed Resubmit the claim with the correct enrolled provider information

Can CARC 170 be appealed?

CARC 170 has a 35% recovery rate and typically resolves in 21-45 days. Resolution difficulty is rated Hard.

CARC Code

170

🔴 Hard Denial

Payment is denied when performed/billed by this type of provider.

35%

Recovery Rate

21-45 days

Avg. Resolution

Hard

Difficulty

Occasional

Frequency

Recommended Action

Verify correct provider type is billing; resubmit under correct provider if applicable

Step-by-Step Resolution

1
Verify the rendering or referring provider's enrollment status with this payer
2
Check that the provider's NPI, taxonomy, and license are current and active
3
If the provider is not enrolled, initiate enrollment before resubmitting
4
Obtain a re-referral or re-order from an enrolled, eligible provider if needed
5
Resubmit the claim with the correct enrolled provider information

Payer-Specific Notes

How major payers handle CARC 170 in practice.

MetLife Dental

MetLife provides detailed denial reason codes — check EOB for supplemental information.

Common 835 Combinations

CARC 170 most often appears with these Group Code + RARC combinations on 835 remittances.

COCO-170Appealable

Look up any combination →

Appeal Letter Template

Enter your email to access the full appeal template for CARC 170.

We are submitting a formal appeal for claim [CLAIM_NUMBER] for patient [PATIENT_NAME], date of service [DOS]. This claim was denied/adjusted with CARC 170 indicating: "Payment denied when performed/billed by this type of provider.." We have reviewed the claim and are providing the attached documentation to support reconsideration. [SUPPORTING_DOCUMENTATION]. Please reconsider payment per the terms of our contract.

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