CO 296 denial code

Claim adjustment reason code 296. Often reported as CO 296.

Authorization not valid for this provider

Unofficial reference. This is our own plain-English explanation, not the official code text. Payer rules differ. Verify with the payer and the official X12 code list. AlphaPrefix is not affiliated with X12, CMS or any payer. Data last updated Nov 11, 2026.

What 296 means

The authorization number may be valid, but it was issued for a different provider than the one who billed.

Authorizations are usually tied to a specific rendering provider, facility, or group. This code says the authorization on file does not cover the provider on the claim.

This often happens when a patient is seen by a different physician or location than the one named in the request.

Group codes seen with 296

On a remittance, 296 comes after a group code. These are the ones it is most often reported with:

• CO 296 (Contractual Obligation): The provider's side of the ledger. The reduction comes from the payer contract or a rule the provider has to follow, and the patient normally cannot be billed for it.

The payer chooses the group code for each adjustment, so the same reason code can appear with another group code on your remittance. Read the two together. More about group codes.

Common causes

• The authorization named a different physician, group, or facility.
• The service moved to another location after the authorization was approved.
• The NPI or tax ID on the claim does not match the authorization.

What to do next

1. Compare the provider details on the authorization with the claim.
2. Ask the payer to update the authorization to the correct provider if its rules allow.
3. Correct the claim if the wrong provider identifiers were billed.

Related codes

• 284 (reason code) Authorization does not match services
• 197 (reason code) No prior authorization on file