CARC 151 appeal letter template — Information Does Not Support Service Frequency/Quantity
CARC 151 means the payer determined that the documentation submitted does not justify the number or frequency of services billed. This template helps staff draft an appeal that presents additional clinical support for the quantity/frequency rendered.
When to appeal vs. correct & resubmit
Appeal when the medical record supports the frequency or quantity of services billed and the denial appears to result from incomplete documentation review, missing clinical notes, or insufficient detail submitted with the original claim. Correct and resubmit instead if the units/frequency were billed in error, exceed what was actually performed, or do not match the documentation on file.
Appeal letter template
Copy the template, replace every [bracketed] field with your details, and keep only the paragraph that fits your situation.
[Date] [Payer Name] Attn: Appeals Department [Payer Address] Re: Appeal of Denial — CARC 151 (Information Does Not Support This Many/Frequency of Services) Patient Name: [Patient Name] Member ID: [Member ID] Claim #: [Claim #] Date(s) of Service: [DOS] Provider: [Provider Name, NPI] CPT/HCPCS: [CPT/HCPCS] Dear Appeals Reviewer, This letter is submitted to formally appeal the denial of the above-referenced claim under CARC 151, which indicates that the payer deems the information submitted does not support this many/frequency of services. We respectfully disagree with this determination and request reconsideration based on the enclosed clinical documentation. The medical record for [Patient Name] supports the frequency and quantity of services billed for [CPT/HCPCS] on [DOS]. Specifically, the documentation demonstrates [describe clinical rationale, condition severity, treatment plan, or progress notes supporting the number/frequency of services]. This information was available at the time of the original claim submission and/or is being provided now to clarify the medical necessity and appropriateness of the service frequency rendered. We ask that [Payer Name] review the enclosed records and reconsider the frequency/quantity determination for claim [Claim #]. If additional clinical documentation, treatment notes, or a peer-to-peer review would assist in this reconsideration, please contact our office at [Phone] or [Email]. If prior authorization was obtained for this frequency of services, authorization number [Authorization #] is referenced for your review. Thank you for your attention to this appeal. We look forward to your response within the timeframe specified by your appeals policy. Sincerely, [Provider Name, NPI] [Practice Name] [Phone] [Email]
What to attach
- Copy of original EOB/ERA showing CARC 151 denial
- Complete medical records/chart notes supporting frequency and quantity of services
- Treatment plan or plan of care documentation
- Physician's orders, if applicable
- Proof of prior authorization (if obtained), including authorization number
- Progress notes documenting medical necessity for each date of service billed
Frequently asked questions
What does CARC 151 mean?
It means the payer reviewed the claim and determined that the submitted information does not support the number or frequency of services billed, often triggering a request for additional documentation or an outright denial of excess units.
What documentation helps most with a CARC 151 appeal?
Detailed chart notes, a treatment plan, physician orders, and progress notes that explain why the specific frequency or quantity of services was clinically appropriate tend to be most useful.
Should I resubmit instead of appealing?
If the billed units or frequency do not match what was actually documented or performed, correct the claim and resubmit rather than appeal.
Can I request a peer-to-peer review for this denial?
Many payers allow a peer-to-peer or clinical review call; check the payer's appeals policy and include a request in your letter if applicable.
More free billing tools: all appeal letters · denial codes · NCCI edits · Medicare fees
This template is for informational purposes only and does not constitute legal, billing, or medical advice. It is a general fill-in-the-blank format to assist with drafting an appeal letter. Outcomes of any appeal are not guaranteed, and each payer's policies and requirements may vary. Consult your organization's compliance, billing, or legal resources as needed.
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