RARC N104: Claim Sent to Wrong Medicare Jurisdiction
Your claim was sent to the wrong Medicare Administrative Contractor — identify the correct MAC for the provider's service area and resubmit the claim there.
What Does RARC N104 Mean?
RARC N104 appears when a Medicare claim is submitted to a Medicare Administrative Contractor (MAC) that does not have jurisdiction over the provider's geographic area or the type of service billed. Medicare divides the country into jurisdictions, each administered by a specific MAC. Claims must be submitted to the MAC that covers the provider's location, and submitting to the wrong one results in this denial.
Jurisdiction confusion most often occurs when a provider operates in multiple states, when a practice relocates, or when the provider is new to Medicare and the billing team selects the wrong MAC during setup. It can also happen with DME claims, which have their own separate jurisdictional MACs (DME MACs) that differ from the Part A and Part B MAC assignments. Home health and hospice claims have yet another set of jurisdictional rules.
This is purely a routing issue — it says nothing about whether the service is covered or whether the claim data is correct. The claim simply needs to go to the right place.
What to Do
Look up the correct MAC for the provider's location and claim type using the CMS MAC jurisdictional map available on cms.gov. Verify whether the claim falls under Part A, Part B, DME, or home health/hospice jurisdiction, as each has different MAC assignments. Update the payer ID in your billing system to route claims to the correct MAC and resubmit.
If you are a multi-state provider, make sure each service location in your billing system is mapped to its correct MAC. When in doubt, the CMS Provider Enrollment and Certification website lists the MAC responsible for each state and claim type. After resubmitting, monitor the claim to confirm it was received by the correct contractor.
Common Scenarios
- A provider with offices in two states submits all claims to one MAC, but the second office falls under a different MAC's jurisdiction
- A DME supplier submits a claim to the Part B MAC instead of the DME MAC, which has separate jurisdictional boundaries
- A new practice sets up Medicare billing with the wrong payer ID and all initial claims are routed to the wrong contractor
- A home health agency submits claims to the local Part A MAC instead of the designated home health and hospice MAC
Commonly Paired With
No common pairings documented yet.