PR-1 denial code: deductible

PR-1 is not a denial in the usual sense. It tells you the payer applied the amount to the patient's deductible, so the patient owes it. The PR group means patient responsibility.

Behavioral health facilities see large PR-1 amounts early in the plan year and on high-deductible plans, where a single residential stay can meet the full deductible.

Check that the deductible amount matches the benefits you verified at admission. If it does, follow your financial policy for the patient balance. If the payer applied in-network cost sharing wrong, or applied a deductible the plan does not have, call the payer and ask for reprocessing before you bill the patient.