PR-3 — Copayment
Claim-adjustment reason code 3 · typically reported as PR-3
What it means
A fixed copay amount was carved out as patient responsibility — most common on Medicare Advantage and commercial DME benefits.
Why DME claims hit it
- MA plans that apply per-item or per-rental-month copays to DME
How to fix it
- Collect the copay; verify plan copay structure at intake so it’s quoted up front
Appeal posture
Nothing to appeal unless the plan misapplied its own benefit design.
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