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PR-2: Coinsurance

UPDATED JULY 2026 · U.S. PLANS · NOT LEGAL OR MEDICAL ADVICE

Your percentage share of the allowed amount after deductible. Expected cost-sharing, but worth verifying.

PR-2 at a glance
  • Code group: PR — Patient Responsibility — the payer assigns this amount to you (verify before paying).
  • Who usually fixes it: You (the member).
  • Worth appealing? Rarely — usually fixed by resubmission.

What to do about a PR-2 denial

  1. Confirm the percentage matches your plan (e.g., 20% in-network).
  2. Check the out-of-pocket maximum — once reached, coinsurance should stop.
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