Healthcare Error Code
Healthcare Insurance / Medical Billing
Patient Responsibility (PR)
PR-1 | Deductible amount
Industry
Healthcare
Canonical
/healthcare/error-codes/pr-1/
Last Updated
Feb 25, 2026
Summary
This code indicates that the charge was applied to the patient’s deductible.
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What This Code Means
PR-1 reflects the portion of the claim that the patient is responsible for under their deductible. Deductibles represent amounts patients must pay before insurance coverage begins. This is a standard cost-sharing mechanism, not a denial. The service itself may be covered, but payment is applied toward deductible limits.
Where Users Usually See This Code
- Explanation of Benefits statements
- Patient billing summaries
- Remittance advice
Why This Code Appears
- The deductible has not been met
- The service is subject to deductible rules
- Annual deductible resets apply
What Typically Happens Next
- The patient balance reflects the deductible amount
- The claim is finalized
- Remaining coverage applies after deductible is met
What This Code Is Not
- It is not a non-covered service
- It is not a billing error
- It is not a denial
Troubleshooting Checklist
- □ Review deductible status
- □ Monitor benefit accumulators
- □ Confirm plan cost-sharing rules
Notes And Edge Cases
Deductibles reset annually. Some services may be exempt from deductible requirements.
Related Codes
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