US No Surprises Act (42 USC 300gg-111 to 300gg-139) and 45 CFR Part 149 149.100: Use the prescribed claim adjustment reason codes and remittance advice remark codes to tell nonparticipating providers whether a claim is subject to the surprise billing rules

What does 149.100 require?

When sending any remittance advice, paper or electronic, to a provider, facility or air ambulance provider that has no direct or indirect contract with the plan or issuer, in response to a claim for items or services it furnished, the plan or issuer must use claim adjustment reason codes and remittance advice remark codes adopted under 45 CFR Part 162, in the manner and timeframe the Departments specify in guidance, to communicate whether the claim is or is not subject to subparts B, E and F. The requirement was added by the final rule published 4 June 2026 and is severable from the QPA, IDR and registry provisions.