Denial code PR-1: Deductible
The patient has not met their yearly deductible, so this amount moves to the patient.
At a glance
| Code | PR-1 (group PR, reason 1) |
| Who owes it | Patient responsibility: The patient owes this amount (deductible, coinsurance, copay or a non-covered service the patient agreed to pay). |
| Type | Patient balance |
| Worth appealing? | Usually not |
How to fix it
- Bill the patient for this amount.
- Collect deductibles at check-in next time using the eligibility check.
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Start free for 14 daysFrequently asked questions
What does denial code PR-1 mean?
The patient has not met their yearly deductible, so this amount moves to the patient.
How do I fix a PR-1 denial?
1. Bill the patient for this amount. 2. Collect deductibles at check-in next time using the eligibility check.
Should I appeal a PR-1 denial?
Usually not. PR-1 is normally an expected adjustment or a duplicate. Confirm the amount is right, then post it.
Can I bill the patient for PR-1?
Yes. PR means patient responsibility, so this amount can be billed to the patient.
Plain-English summary for billing staff, not the official code text. See x12.org/codes for the official wording, and always follow the payer's own policy.