PR-235: Sales Tax
The patient owes the sales tax. Collect from the patient.
What Does PR-235 Mean?
With PR, the patient is responsible for the sales tax on the product. Collect from the patient.
CARC 235 indicates a sales tax component on the claim. Some states impose sales tax on medical products, equipment, or supplies, and this code reflects the tax adjustment in the claim processing. The payer may be adding, adjusting, or denying the sales tax component depending on the jurisdiction and the specific product billed.
Sales tax rules vary significantly by state — some states exempt medical devices and prescription drugs from sales tax, while others impose tax on DME, medical supplies, or over-the-counter products. The treatment of sales tax on insurance claims depends on both state law and the payer's policy.
Common Causes
| Cause | Frequency |
|---|---|
| Patient responsible for sales tax on medical equipment/supplies Sales tax on durable medical equipment or supplies is assigned to the patient rather than covered by the payer | Common |
How to Resolve
- Verify the tax Confirm the tax amount is correct.
- Collect from the patient Include the sales tax in the patient statement.
The patient is responsible for applicable sales tax. Collect the amount from the patient.
How to Prevent PR-235
- Inform patients about sales tax on applicable products at the time of purchase
General Prevention
- Inform patients about their sales tax responsibility at time of purchase/delivery
Also Filed As
The same CARC 235 may appear with different Group Codes:
Related Denial Codes
Sources
- https://x12.org/codes/claim-adjustment-reason-codes
- https://portal.ct.gov/-/media/ohs/health-it-advisory-council/apcd-advisory-group/data-submission-guide-workgroup/meeting-materials/6-30-22/carc-codes_final.pdf
- https://www.aapc.com/resources/claim-adjustment-reason-codes
- Codes maintained by X12. Visit x12.org for official definitions.