PR-202 means the plan treated a charge as a personal comfort or convenience item and won’t cover it. Think of a TV in the room, a phone line, guest meal trays or an admission kit of toiletries. With group code PR, the plan says the patient may owe it. Before you bill the patient, check two things: did the patient ask for the item, and was the charge really a comfort item rather than a medical supply? (Primary source: X12 Claim Adjustment Reason Codes)
In brief: CARC 202 reads “Non-covered personal comfort or convenience services.” Check the revenue code and the item. If it’s a real comfort item the patient chose, bill the patient under your policy. If a medical supply was mapped to a comfort code, fix FL 42 and send a replacement claim so the patient isn’t billed by mistake.
Part of our denial codes library. Written by Manikandan J, CPC, CRCR, who has reviewed hospital charge masters and patient billing disputes for inpatient units. Published 22 October 2026. Last updated: 22 October 2026. Code wording quoted word for word from X12.
Official CARC 202 description
| Field | X12 text |
|---|---|
| Code | 202 |
| Description | “Non-covered personal comfort or convenience services.” |
| Start | 02/28/2007 |
| Last modified | 09/30/2007 |
Source: X12 Claim Adjustment Reason Codes, checked 22 October 2026.
What counts as personal comfort or convenience
A personal comfort item is something that makes a stay nicer but doesn’t treat the patient’s condition. Hospitals report these with the 099X revenue codes on the UB-04. A medical supply is an item used in care, reported under 027X codes. The difference decides who pays.
| Revenue code | Item | Usually |
|---|---|---|
| 0991 | Cafeteria or guest tray | Comfort, often patient-paid |
| 0993 | Telephone | Comfort |
| 0994 | TV or radio | Comfort |
| 0997 | Admission kit | Comfort under many plans |
| 0270 | Medical or surgical supplies, general | Medical supply |
See NUBC for the official revenue code list, and HealthCare.gov’s excluded services entry for how plans describe exclusions.
Example scenario (fictional names), part 1
PR-202 Denial Example: What Happened
Sandra Lopez works in patient accounts at Willow Creek Medical Center. A patient had a normal full-term delivery (O80, Z37.0) and went home after two days. Her claim to Thornbury Health, a fictional commercial plan, included a postpartum perineal care kit with an ice pack and peri bottle. The charge master had that kit under revenue code 0997, the admission kit code.
The 835 showed CAS*PR*202 on the kit line with remark LQ*HE*N130, “Consult plan benefit documents/guidelines for information about restrictions for this service.” The patient called, upset about a bill for her postpartum supplies.
Was the kit a comfort item, or had the hospital filed a medical supply in the wrong place? Keep reading, or jump to how the PR-202 denial was resolved.
Why plans apply reason code 202
- True comfort items. For example, TV, phone, guest trays, late checkout or a private room by patient choice.
- Charge master mapping errors. Medical supplies placed under 099X comfort codes, so the plan treats them as convenience items.
- Bundled kits. A kit with both comfort items and medical supplies, coded as one comfort item.
- Plan exclusions. Some plans list specific items, such as personal care products, as excluded comfort items.
How to work a PR-202 denial
- Identify the item. Look at what the charge really was, not just its name on the bill.
- Check the revenue code. If the item is used in care, it belongs under a supply code such as 0270, not 099X.
- Fix the source. Correct the charge master entry so the item maps to the right revenue code.
- Send a replacement claim with type of bill frequency 7 (for example 0117 for an inpatient stay) and the original claim number in FL 64.
- If it’s a true comfort item, check that the patient asked for it and was told of the cost, then bill under your policy.
- Hold patient statements for any line under review, so the patient isn’t billed while you fix it.
Example scenario (fictional names), part 2
How the PR-202 Denial Was Resolved
Sandra checked the kit’s contents with the maternity unit. The ice pack, peri bottle and pads were postpartum care supplies the nurses used for every patient, not items she asked for. The kit had been set up under 0997 when the unit changed suppliers.
Fix: the charge master team moved the kit to revenue code 0270. Sandra sent a replacement claim (type of bill 0117) with 0270 in FL 42 and the original claim number in FL 64. She held the patient’s statement.
Outcome: Thornbury processed the kit as a covered supply in the delivery stay, and the patient owed nothing for it. Willow Creek audited all 099X entries and found two more supplies in the wrong place.
Names and details are illustrative; no real patient data.
CMS-1500 not shown: comfort items are facility charges coded by revenue code (FL 42), which the CMS-1500 doesn't have.
- FL 42: postpartum care kit moved from 0997 (admission kit, a comfort code) to 0270 (medical/surgical supplies, general).
- FL 4 + FL 64: type of bill 0117 (inpatient replacement) with the original claim number.
- FL 67: O80 and Z37.0 (entered as Z370) are unchanged.
- CMS-1500: no equivalent box; comfort-item revenue codes are facility-only.
PR-202 vs related codes
| Code | What it says | Key difference |
|---|---|---|
| PR-202 | Non-covered personal comfort or convenience services | Comfort item exclusion |
| CO-96 | Non-covered charge(s) | General non-covered, provider liable |
| PR-204 | Not covered under the patient’s current benefit plan | Plan benefit exclusion |
| CO-199 | Revenue code and procedure code don’t match | Coding pair error |
Prevention checklist
- Review every 099X charge master entry once a year.
- Don’t put medical supplies in kits coded as comfort items.
- Tell patients the cost of comfort items before they use them.
- Hold statements on lines under review.
Recap
PR-202 means the plan treated a charge as a personal comfort or convenience item. Check what the item really was. Bill the patient only for true comfort items they chose. When a medical supply landed under a 099X code, fix the charge master and send a replacement claim.
FAQ
What does PR-202 mean?
The plan says the charge is a non-covered personal comfort or convenience service, so the patient may be responsible.
Can I bill the patient for a PR-202 line?
Yes, when it’s a real comfort item the patient chose and your policy allows it. Check the item first.
Which revenue codes are personal comfort items?
The 099X range, such as 0991 guest trays, 0993 telephone and 0994 TV.
Does PR-202 apply to professional claims?
Rarely. Comfort items are facility charges, and the CMS-1500 has no revenue code field.
How do I fix a supply billed as a comfort item?
Move it to the right revenue code, such as 0270, and send a replacement claim with frequency 7.
Sources
How we checked: each code quote on this page was matched word for word with the X12 CARC and RARC lists on 22 October 2026.
- X12, Claim Adjustment Reason Codes (CARC 202, 96, 204, 199). Accessed 22 Oct 2026.
- X12, Remittance Advice Remark Codes (N130). Accessed 22 Oct 2026.
- NUBC, UB-04 data specifications. Accessed 22 Oct 2026.
- HealthCare.gov, Excluded services. Accessed 22 Oct 2026.
Last updated: 22 October 2026 · Educational content; not legal advice.