Healthcare Error Code
Healthcare Insurance / Medical Billing
Claim Adjustment Reason Codes (CARC)

CO-133 | Incorrect provider type

Industry
Healthcare
Canonical
/healthcare/error-codes/co-133/
Last Updated
Feb 25, 2026
Summary

This code indicates that the provider type submitted does not match payer requirements for the service.

Advertisement after-summary
Ad Space

What This Code Means

CO-133 is applied when the provider type reported is not eligible to bill for the service under payer rules. Provider eligibility is defined by enrollment and scope of practice. This is an administrative validation issue rather than a coverage decision. The service itself may be valid but billed under an ineligible provider type.

Where Users Usually See This Code

  • Remittance advice
  • Claim rejection notices
  • Provider enrollment reports

Why This Code Appears

  • Provider type not eligible for service
  • Enrollment records not updated
  • Payer provider rules enforced

What Typically Happens Next

  • Claim is denied or adjusted
  • Reprocessing may be required
  • Payment is delayed or not issued

What This Code Is Not

  • It is not a non-covered service
  • It is not patient responsibility
  • It is not a duplicate claim

Troubleshooting Checklist

  • Verify provider enrollment details
  • Review payer provider eligibility rules
  • Monitor enrollment status

Notes And Edge Cases

Provider eligibility rules vary by payer and program. Enrollment updates can affect provider type recognition.

Related Codes

8 links
Advertisement near-bottom
Ad Space
ErrorCodesIndex logo