N192 remark code

Remittance advice remark code N192. Remark codes add detail to the reason code on the same claim line.

Patient is Medicaid or QMB

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 N192 means

An alert that the patient is a Medicaid recipient or Qualified Medicare Beneficiary, which limits what you can collect from them.

N192 is an informational alert, not a reason for nonpayment. It tells you the patient has Medicaid or Qualified Medicare Beneficiary status, which usually means cost sharing goes to the state program rather than the patient.

Use it as a cue to check balance billing rules before sending a statement, and to make sure the claim crosses over or is billed to the secondary program.

Common causes

• The payer's records show the patient as dually enrolled in Medicare and Medicaid.
• The patient is enrolled in a Qualified Medicare Beneficiary program.
• The payer adds this alert whenever cost sharing remains on a dually eligible patient's claim.

What to do next

1. Check the patient's Medicaid or QMB status and add the secondary coverage to the account.
2. Hold patient statements for deductible, coinsurance and copays until rules for this patient are confirmed.
3. Bill the remaining cost sharing to the Medicaid program if it did not cross over.
4. Train front-desk staff not to collect cost sharing from patients with this status.

Related codes

• N781 (remark code) QMB or Medicaid patient: deductible
• N830 (remark code) Balance billing protections apply
• N767 (remark code) Provider not enrolled in state Medicaid