PR-2 Denial Code Explained
PR-2 is a medical billing denial code that indicates the patient is responsible for the coinsurance amount associated with the insurance claim. This adjustment commonly occurs when insurance plans require patients to share a percentage of covered medical costs.
PR CODES
Omar Villafuerte
3/7/20221 min read
PR-2 Denial Code Explained
PR-2 is a medical billing denial code that indicates the patient is responsible for the coinsurance amount associated with the insurance claim. This adjustment commonly occurs when insurance plans require patients to share a percentage of covered medical costs.
What Does PR-2 Mean?
The PR-2 denial code means a portion of the claim balance has been assigned to the patient as coinsurance responsibility under the insurance policy terms.
Coinsurance amounts are typically calculated after deductibles have been applied.
Common Reasons for PR-2
Patient coinsurance responsibility
Insurance cost-sharing requirements
Percentage-based patient balance
Plan-specific reimbursement structure
Covered service patient obligation
How To Handle PR-2
Review the patient’s explanation of benefits (EOB) and confirm the coinsurance amount assigned by the payer. Providers may bill the patient directly for the remaining balance according to payer guidelines and financial agreements.
Benefit verification before treatment can help reduce patient billing confusion.
Related Denial Codes
You may also encounter:
Quick Summary
PR-2 indicates the patient is responsible for the coinsurance portion of the claim balance. These adjustments are commonly related to insurance plan cost-sharing requirements.
Medical billing denial codes, insurance prefixes, and claim guidance in one searchable resource hub.
© 2026. All rights reserved.
Quick Links
Denial Codes
BCBS Prefixes
Articles
Resources
About ClariMed
Terms and Conditions
Privacy Policy
