What does denial code CO-24 mean?

CO-24 means the service is covered under a capitation agreement or a managed care plan, so this payer is not responsible for paying it. It most often signals that the patient has a Medicare Advantage plan or is assigned to a capitated medical group that pays its providers directly.

Can I bill the patient after a CO-24 denial?

No. The care is covered - it is simply owed by a different entity. Billing the patient because the wrong payer was invoiced is a billing error, not a patient balance. Identify the managed care plan or capitated group and rebill there.

CO-24: Charges are covered under a capitation or managed care arrangement

CO-24 is one of the most misread codes on a remittance because it looks like a denial and is actually a routing message. It appears most often when a patient has elected a Medicare Advantage plan and the claim went to traditional Medicare, or when a member is assigned to a capitated medical group that pays its contracted providers directly. The care is covered; you simply billed an entity that has already delegated the risk to someone else.

What it means: The patient's benefits for this service are administered under a capitated contract or a managed care plan, so this payer is not the one that pays the claim.
Who pays the balance: Not the patient's - the balance belongs to the capitated group or the managed care plan that holds the member.
Group code CO: Contractual Obligation - the provider absorbs the balance and cannot bill the patient

Why CO-24 happens

The patient enrolled in a Medicare Advantage plan and the claim was submitted to traditional Medicare instead.
The member is assigned to a capitated medical group or IPA that pays its own contracted providers for this service.
The service falls inside a capitated bundle the group already receives a per-member payment for.
Eligibility was checked before an enrollment change took effect, so the plan on file was already stale at the date of service.
The patient presented an old card and the newer managed care plan was never captured.

How to fix a CO-24 denial

1
Re-run eligibility for the date of service, not for today
Enrollment changes are effective-dated, and an eligibility check run now can show a completely different plan than the one that governed the visit. Query the date of service specifically.
2
Identify the plan or capitated group that holds the member
The remark codes often name it. If not, the payer's eligibility response usually identifies the managed care plan or the delegated group and the address to bill.
3
Confirm whether you are contracted with that entity before billing
Capitated groups frequently pay only their own contracted providers. If you are out of network with the delegated group, the answer may be a single-case agreement rather than a clean rebill.
4
Rebill the correct entity within its filing window
The new payer's timely filing clock generally runs from the date of service, not from the date of this denial, so time already spent counts against you.

Deadlines depend on the payer

Filing limits and appeal windows for CO-24 vary by payer and often by plan type within the same payer. Look up the specific payer to see its verified deadlines and the source document they came from.

Browse payer billing references

Preventing CO-24 denials

Verify eligibility at every visit rather than at registration only, since managed care enrollment changes mid-year.
Flag Medicare Advantage enrollment explicitly at check-in, because the card often resembles a supplement.
Keep a current list of the capitated groups in your market and which of them you actually hold contracts with.

CO-24 frequently asked questions

What does denial code CO-24 mean?: CO-24 means the service is covered under a capitation agreement or a managed care plan, so this payer is not responsible for paying it. It most often signals that the patient has a Medicare Advantage plan or is assigned to a capitated medical group that pays its providers directly.
Can I bill the patient after a CO-24 denial?: No. The care is covered - it is simply owed by a different entity. Billing the patient because the wrong payer was invoiced is a billing error, not a patient balance. Identify the managed care plan or capitated group and rebill there.

Related denial codes

CO-19 CO-109 CO-22 CO-256

Last reviewed August 5, 2026.

Denial code explanations are original plain-English summaries written for reference and are not the official X12 code descriptions. Payer handling of any code varies by contract - always verify against the remittance advice and your payer agreement before adjusting a claim.