CO-96 means non-covered charges. Like CO-16, it needs a remark code to tell you why, so read the remark code before anything else.
On behavioral health facility claims, CO-96 often reflects a plan exclusion: no residential benefit, no out-of-network benefit, or an excluded program type.
Get the plan's benefit language. If the exclusion is real and applies, the balance may be the patient's under your financial policy and any advance notice they signed. If a behavioral health exclusion is stricter than how the plan treats comparable medical care, ask whether a parity-based appeal applies.
Questions
What is the difference between CO-96 and CO-204?
Both mean not covered. CO-204 says the service is not covered under the patient's current benefit plan; CO-96 relies on a remark code for the reason.
Should I appeal a CO-96?
Only after reading the remark code and the plan language. Many are real exclusions.
Read next
Educational summary, not billing advice. Official code descriptions are at x12.org. Checked October 2026.