OA-137: Regulatory Surcharges, Assessments, or Health-Related Taxes

What Does OA-137 Mean?

When paired with Group Code OA, CARC 137 (Regulatory Surcharges, Assessments, or Health-Related Taxes) is processed as an adjustment outside the standard CO/PR classifications. This typically occurs in secondary payer or coordination of benefits scenarios. Review the remittance details and the COB arrangement to determine financial responsibility and appropriate next steps.

CARC 137 appears on a remittance when the payer applies an adjustment for regulatory surcharges, assessments, or health-related taxes. Review the group code and any accompanying RARC codes to understand the full context of this adjustment.

Common scenarios that trigger this adjustment include: the state imposes a health-related tax or assessment on provider payments, and CARC 137 reflects the deduction from the payment; A regulatory surcharge mandated by federal or state law is applied to the claim payment, reducing the net amount the provider receives; The payer passes through a portion of health insurer fees or assessments to the provider per the contractual or regulatory framework. The group code paired with CARC 137 determines who bears the financial responsibility — OA indicates a coordination of benefits or other payer adjustment, CO places it on the provider as a contractual obligation, PR shifts it to the patient.

Common Causes

How to Resolve

1. Review the coordination of benefits Examine the OA-137 adjustment to understand how it fits within the primary/secondary payer relationship or other multi-payer context.
2. Verify primary payer adjudication Review the primary payer's EOB to understand the basis for the secondary payer's OA adjustment.
3. Determine the responsible party Based on the COB review, identify whether the adjustment should be absorbed, billed to another payer, or if additional documentation is needed.
4. Follow up Monitor the claim status and take additional action as needed based on the COB determination.

Common RARC Pairings

The RARC code tells you exactly what triggered the OA-137:

How to Prevent OA-137

• Monitor federal and state regulatory changes that may affect provider payment deductions
• Budget for known regulatory surcharges and assessments in revenue cycle projections
• Ensure billing and finance staff understand the regulatory basis for these deductions
• Reconcile regulatory deductions against the applicable rates on a regular basis
• Track regulatory adjustment trends by payer for financial planning

Also Filed As

The same CARC 137 may appear with different Group Codes:

Related Denial Codes