Healthcare Error Code
Healthcare Insurance / Medical Billing
Patient Responsibility (PR)

PR-3 | Copayment

Industry
Healthcare
Canonical
/healthcare/error-codes/pr-3/
Last Updated
Feb 25, 2026
Summary

This code indicates that a fixed copayment amount is the patient’s responsibility.

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What This Code Means

PR-3 reflects a fixed cost-sharing amount required under the patient’s plan. Copayments are predetermined and apply to specific services. This is a standard plan feature and does not indicate denial. The remaining portion may be covered by insurance.

Where Users Usually See This Code

  • EOB documents
  • Patient billing statements
  • Remittance advice

Why This Code Appears

  • Copayment applies to the service type
  • Plan benefit rules enforced
  • Service category requires copayment

What Typically Happens Next

  • Patient is billed for the copayment
  • Insurance covers remaining eligible charges
  • Claim processing completes

What This Code Is Not

  • It is not a non-covered service
  • It is not a billing error
  • It is not a deductible amount

Troubleshooting Checklist

  • Review copayment schedule
  • Confirm service category
  • Monitor benefit summaries

Notes And Edge Cases

Copayment amounts vary by service and plan. Some preventive services may not require copayments.

Related Codes

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