CO P20 denial code

Claim adjustment reason code P20. Often reported as CO P20.

Not paid under facility fee schedule

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 P20 means

On a property and casualty claim, the service is not payable under the jurisdiction's outpatient facility fee schedule.

You will see it only on property and casualty remittances, for example from a workers' compensation or auto carrier. It applies to facility billing: the jurisdiction's outpatient facility fee schedule does not allow payment for the service as billed by the facility.

The service may be payable as a professional service or under another schedule, depending on the jurisdiction's rules.

Group codes seen with P20

On a remittance, P20 comes after a group code. These are the ones it is most often reported with:

• CO P20 (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 service is not a payable item in the outpatient facility schedule.
• The service was billed on a facility claim instead of a professional claim.
• The facility type does not qualify under the schedule.

What to do next

1. Check the jurisdiction's outpatient facility fee schedule for the service.
2. Check whether the service should be billed on a professional claim instead.
3. Correct and resubmit, or post as an adjustment if non-payable.

Related codes

• P12 (reason code) Workers' comp fee schedule adjustment
• P19 (reason code) Zero relative value in fee schedule