Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code 1

SAS Name

This field represents the benefit enhancement indicator that identifies these are Next Generation (NG) Accountable Care Organization (ACO) claims that qualify for specific claims processing edits.


This field comes from the CLM-NG-ACO-IND-1-CD that is present on the first claim record included in the stay. If there is no CLM-NG-ACO-IND-1-CD on the first claim then take the first found code on any of the other claims that make up the stay.

This field is new in 2015.

Source: NCH

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