CO-300: Medical Plan Benefits Not Available - Submit to Behavioral Health
CO-300 means the medical plan contractually denies the service and forwarded it to behavioral health. Wait for the behavioral health plan's determination.
What Does CO-300 Mean?
When CARC 300 appears with CO, the medical plan is contractually denying the behavioral health service and forwarding it. The provider cannot post as a contractual adjustment for the medical plan denial while waiting for the behavioral health plan to adjudicate.
CARC 300 is a claim routing code indicating the medical plan received the claim, determined the service belongs under behavioral health coverage, and has automatically forwarded it to the patient's behavioral health plan for processing. This code is a forwarding confirmation, not a final denial.
This code is common in managed care arrangements where behavioral health benefits are carved out and managed by a separate entity. Many employers and health plans contract with specialty behavioral health organizations like Optum Behavioral Health, Carelon Behavioral Health, or Magellan to administer mental health and substance abuse benefits separately from medical/surgical benefits. When a provider submits a behavioral health claim to the medical plan, the medical plan recognizes the service type and routes it to the carved-out behavioral health administrator.
The distinction between CARC 300 and CARC 301 is important. CARC 300 means the medical plan has forwarded the claim to the behavioral health plan on your behalf. CARC 301 means the medical plan is telling you to submit the claim to the behavioral health plan yourself. With CARC 300, the claim should already be in the behavioral health plan's queue, but active follow-up is still recommended to ensure the forwarding was successful.
Common Causes
| Cause | Frequency |
|---|---|
| Behavioral health service submitted to medical plan instead of behavioral health plan The claim was filed with the medical insurance plan but the services are behavioral/mental health in nature and should be submitted to the patient's behavioral health plan | Most Common |
| Service classified as behavioral health benefit The payer determined the service falls under the behavioral health benefit rather than the medical plan | Common |
| Coordination of benefits requires behavioral health plan review The medical plan determined the service should be evaluated by the behavioral health plan under COB rules | Common |
| Incorrect insurance information or plan routing The patient's insurance details were not properly recorded, causing the claim to be routed to the medical plan instead of the behavioral health plan | Occasional |
| Service falls under carve-out behavioral health contract The payer has a separate carve-out contract for behavioral health services with a different administrator | Occasional |
How to Resolve
- Track behavioral health plan processing Monitor the behavioral health plan's adjudication. Do not take any write-off action until the behavioral health plan has processed the claim.
- Post adjustments after determination Once the behavioral health plan processes the claim, post payment or adjustments accordingly.
CARC 300 is a plan routing notification directing the provider to submit the claim to the patient's behavioral health plan. Resubmit to the behavioral health plan rather than appealing the medical plan's determination.
Common RARC Pairings
The RARC code tells you exactly what triggered the CO-300:
| RARC | Description |
|---|---|
| N590 | Alert: This service may be covered under the patient's behavioral health plan. Submit the claim to the patient's behavioral health insurance plan for consideration → |
How to Prevent CO-300
- Submit behavioral health claims directly to the carved-out behavioral health plan to avoid routing delays
- Maintain current contact information and payer IDs for all behavioral health plan administrators
General Prevention
- Verify eligibility with the correct plan (medical vs behavioral health) before claim submission
- Understand plan-specific coverage details and carve-out arrangements for behavioral health services
- Coordinate proactively with Behavioral Health Plans when providing mental health services
- Document medical necessity comprehensively for behavioral health services
- Stay current with plan policy changes affecting medical vs behavioral health benefit boundaries
- Train staff on proper routing of behavioral health claims
Also Filed As
The same CARC 300 may appear with different Group Codes:
Related Denial Codes
Sources
- https://www.mdclarity.com/denial-code/300
- https://resdac.org/sites/datadocumentation.resdac.org/files/Adjustment%20Reason%20Code%20Code%20Table%20(TAF%20Claims).txt
- https://x12.org/codes/claim-adjustment-reason-codes
- Codes maintained by X12. Visit x12.org for official definitions.