Who has to pay after a code 117 denial?

Who owes depends on the details. The letters in front of the number matter: CO (contractual obligation) usually means an in-network provider must absorb it, while PR (patient responsibility) means the plan says you owe it.

How long do I have to appeal?

It depends on your coverage: 180 days for most employer and marketplace plans, 120 days for Original Medicare, about 90 days for Medicaid (varies by state), and only 65 days for Medicare Advantage. Set your deadline clock before you do anything else.

All denial codes · code 117

Denial code 117: what it means — and how to fight it

Denial code 117 (shown on your EOB as CO-117 or PR-117) means: “Transportation is only covered to the closest facility that can provide the necessary care.” In plain English: They'll only pay to take you to the nearest place that could treat you. If the closest facility couldn't handle your condition, you can appeal.

medium appealability Who owes depends on the details

What they're really saying

“Transportation is only covered to the closest facility that can provide the necessary care.”

They'll only pay to take you to the nearest place that could treat you. If the closest facility couldn't handle your condition, you can appeal.

Your odds

Worth fighting — many of these get fixed.

Documented lack of nearby capability often wins the difference.

Fewer than 1 in 100 denied claims are ever appealed. When people do appeal, roughly 4 in 10 win the first round — and independent external review overturns 40–50% of what reaches it.

How to appeal a code 117 denial

Decode. You just did — this page is step one.
Set your clock. 180 days for most employer and marketplace plans, 120 for Original Medicare, ~90 for Medicaid, only 65 for Medicare Advantage.
Urgent? If this is care you still need, call and request an expedited appeal — they must decide within 72 hours.
Ask the doctor to confirm the nearest facility couldn't treat you. Get a physician statement that the closer facility lacked the needed level of care (trauma, cardiac, specialty), so transport to a farther one was medically necessary. For emergencies, cite the prudent-layperson standard.
Send it certified. Letter plus evidence, keep copies of everything.
Escalate. Denied again? Independent external review — a doctor who doesn't work for your insurer decides.

Do it in minutes, free

The AppealClock tool translates your denial, drafts your appeal letter, computes your exact deadline — and watches the clock so you don't have to. No account. Your medical details never leave your device.

Start your appeal & set your clock →

Common questions

What does denial code 117 mean?: They'll only pay to take you to the nearest place that could treat you. If the closest facility couldn't handle your condition, you can appeal.
Can I appeal a CO-117 or PR-117 denial?: Yes. Appealing is free and it is your legal right. For this code the odds are medium: Documented lack of nearby capability often wins the difference. Fewer than 1 in 100 denials are ever appealed — insurers count on silence.
Who has to pay after a code 117 denial?: Who owes depends on the details. The letters in front of the number matter: CO (contractual obligation) usually means an in-network provider must absorb it, while PR (patient responsibility) means the plan says you owe it.
How long do I have to appeal?: It depends on your coverage: 180 days for most employer and marketplace plans, 120 days for Original Medicare, about 90 days for Medicaid (varies by state), and only 65 days for Medicare Advantage. Set your deadline clock before you do anything else.