ResDAC is currently experiencing a high volume of requests, which may delay response and processing times. We are working to address the backlog as quickly as possible and appreciate your patience.
This variable is contained in the following files:
SAS Name
HOP_BENE_PMT
This variable is the sum of Medicare coinsurance and deductible payments in the hospital outpatient (HOP) setting for a given year. The total beneficiary payment is calculated as the sum of the beneficiary deductible amount and coinsurance amount (variables called REV_CNTR_CASH_DDCTBLE_AMT and REV_CNTR_COINSRNC_WGE_ADJSTD_C) for all HOP claims where the CLM_PMT_AMT >= 0.
Costs that beneficiaries are liable for are described in detail on the Medicare.gov website. There is a CMS publication called "Your Medicare Benefits", which explains the deductibles and coinsurance amounts.
Medicare payments are described in detail in a series of Medicare Payment Advisory Commission (MedPAC) documents called “Payment Basics”.
Also in the Medicare Learning Network (MLN) “Payment System Fact Sheet Series”.
Source: CCW (derived)