Health insurance denial & claim adjustment codes

What health insurance denial code 24 means on your EOB

A capitated arrangement — the plan pays the provider a flat rate, so this is not billable to you.

What usually causes it

• The provider is paid by capitation.
• The service falls inside the capitated scope.
• No separate fee-for-service payment applies.

The documents that decide it

• Your EOB.
• The provider's network arrangement.
• Any bill received.

What to do next

Capitated services are generally not separately billable to you. A bill for one is worth questioning.

This page explains what a code means. It is information, not advice — it does not tell you whether your specific claim should have been paid, and it is not legal, medical, or insurance advice. Your plan documents and your denial notice govern your situation.