Who has to pay after a code 287 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 287

Denial code 287: what it means — and how to fight it

Denial code 287 (shown on your EOB as CO-287 or PR-287) means: “Referral exceeded.” In plain English: Your referral covered a certain number of visits or a date range, and you went past it. The care itself was not rejected.

medium appealability Who owes depends on the details

What they're really saying

“Referral exceeded.”

Your referral covered a certain number of visits or a date range, and you went past it. The care itself was not rejected.

Your odds

Worth fighting — many of these get fixed.

Often fixable — a new or extended referral plus a rebill usually resolves it.

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 287 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 your primary care office to extend or reissue the referral, then rebill. Ask your primary care office to extend the referral or issue a new one, and request that it be backdated if your plan allows it. Then have the specialist rebill. Count the visits yourself against the referral: plans and offices lose track, and you may not actually have exceeded it. If your primary care office simply failed to renew a referral it had agreed to, that error is theirs, not yours.
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 287 mean?: Your referral covered a certain number of visits or a date range, and you went past it. The care itself was not rejected.
Can I appeal a CO-287 or PR-287 denial?: Yes. Appealing is free and it is your legal right. For this code the odds are medium: Often fixable — a new or extended referral plus a rebill usually resolves it. Fewer than 1 in 100 denials are ever appealed — insurers count on silence.
Who has to pay after a code 287 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.