Pioneer Accountable Care Organization (ACO) Reduction CARC
If the claim has a demonstration code equal to “59” (Pioneer ACO Demonstration) or “68” (Pioneer ACO SNF), and provided service is from an outpatient provider (TOB equal to 12, 13, 14, 22, 23, 34, 71, 72, 74, 75, 76, 77, 81, 82, 85) or the service is for home health Part B; this field will identify the applicable Claim Adjustment Reason Code (CARC) that defines why the service was paid differently than billed.
Some additional information on this variable: