PR-3: Copayment
UPDATED JULY 2026 · U.S. PLANS · NOT LEGAL OR MEDICAL ADVICE
The fixed per-visit amount your plan assigns. Routine — but miscategorized visits produce wrong copays.
PR-3 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-3 denial
- Check the visit type: specialist vs. primary vs. preventive copays differ, and preventive visits are often $0.
- Ask the provider to re-code if a preventive visit was billed as diagnostic.
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