N767 remark code

Remittance advice remark code N767. Remark codes add detail to the reason code on the same claim line.

Provider not enrolled in state Medicaid

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 N767 means

The patient's state Medicaid program requires the provider to be enrolled with it before any claim can be processed.

N767 comes from Medicaid programs, including managed Medicaid plans. The state requires every provider billing for its members to be enrolled with the state Medicaid agency, even if the provider is contracted with the plan or enrolled in another state.

It explains a provider eligibility reason code. Claims are usually reprocessed once enrollment is in place, subject to the program's rules on effective dates.

Common causes

• The provider is enrolled in a different state's Medicaid program but not the patient's state.
• A new provider joined the group before completing state Medicaid enrollment.
• The provider's state Medicaid enrollment lapsed or was not revalidated.

What to do next

1. Check the provider's enrollment status with the patient's state Medicaid program.
2. Start or complete state enrollment and ask about the earliest effective date allowed.
3. Resubmit or ask for reprocessing once enrollment is active.
4. Screen out-of-state Medicaid patients for this requirement before the visit.

Related codes

• N570 (remark code) Credentialing data problem
• N290 (remark code) Rendering provider ID problem
• N192 (remark code) Patient is Medicaid or QMB