CO-147CO group · Credentialing

CO-147 denial code: the negotiated provider rate has expired or is absent

CO-147 means the contract exists somewhere and the fee schedule behind it does not, and claims cannot price without it.

CO-147 fires when the payer has no negotiated rate on file for the provider or the service. The contract may have lapsed, may never have been loaded, or may not include the service billed.

What CO-147 means

Rate loading is an operational step separate from signing, and it fails quietly. A newly contracted provider whose rates were never loaded, a renewal that lapsed at a term boundary, or a service added to the practice that the existing schedule does not price all produce it. Nothing on the claim can fix it, and every claim will deny identically until the schedule is corrected — which makes provider relations, not appeals, the right destination.

Why CO-147 fires

  • A newly contracted provider's rates were never loaded.
  • The contract term lapsed and was not renewed in the system.
  • The service is outside the schedule the contract loaded.
  • A rate change was agreed and not implemented.

Is CO-147 worth appealing?

Sometimes worth appealing

Take it to provider relations rather than appeals. Once the rate is loaded, ask for every claim denied in the interim to be reprocessed together.

How to resolve or appeal CO-147

  1. 1

    Confirm the contract status

    Effective dates and whether the schedule was actually loaded.

  2. 2

    Ask for bulk reprocessing

    Every claim denied while the rate was missing, not just the current one.

CO-147 — frequently asked

Is this an appeal?
Not really. There is no determination about the care — the claim could not price. Appeals staff generally cannot load a rate; contracting can.
Will resubmitting help?
No. Until the schedule is loaded, the same denial repeats on every submission.

Related guides

CO-45 · Allowed amountCO-B7 · CredentialingCO-208 · Administrative

Sources

Reason-code meanings are paraphrased from the X12 Claim Adjustment Reason Code list for plain-language reference; they are not reproduced verbatim. This is general information, not legal, coding, or medical advice — always confirm against the payer's remittance and policy.

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