Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code - Telehealth

This variable is contained in the following files:

Carrier (Fee-for-Service) Durable Medical Equipment (Fee-for-Service) Home Health Agency (Fee-for-Service) Hospice (Fee-for-Service) Inpatient (Fee-for-Service) Outpatient (Fee-for-Service) Skilled Nursing Facility (Fee-for-Service)

SAS Name

CLM_NEXT_GNRTN_ACO_IND_CD2

The field identifies the claims that qualify for specific claims processing edits related to benefit enhancement through the Next Generation (NG) Accountable Care Organization (ACO).

Comments

Source: NCH

Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code 1-5 Code Book (FFS)_13.txt848 bytes

Code	Code value
0	Base record (no enhancements)
1	Population Based Payments (PBP)
2	Telehealth
3	Post Discharge Home Health Visits
4	3-Day SNF Waiver
5	Capitation
6	CEC Telehealth
7	Care Management Home Visits
8	Primary Care Capitation (PCC)
9	Home Health Benefit Enhancement — eff. 4/2021
B	Concurrent Care for Beneficiaries that Elect the Medicare Hospice Benefit — eff. 4/2021
C	Kidney Disease Education (KDE) — eff. 4/2021
D	Seriously Ill Population (SIP)
E	Flat Visit Fee (FVF)
F	Quarterly Capitation Payment (QCP) — eff. 4/2021
G	Performance Based Adjustment (PBA) — eff. 7/2022