Imaging Beneficiary Payments

SAS Name
IMG_BENE_PMT

This variable is the sum of coinsurance and deductible payments for imaging services (IMG) for a given year. The total beneficiary payments are calculated as the sum of LINE_COINSRNC_AMT + LINE_BENE_PTB_DDCTBL_AMT for the relevant lines.

Claims for imaging procedures are a subset of the claims, and a subset of procedures in the Part B Carrier and DME data files. These imaging claims are defined as those with a line BETOS code (BETOS_CD) where the first digit = I (except for 'I1E', or 'I1F' – which are considered Part B drugs).

Comments

There are 11 cost/use categories from the Carrier Part B and DME data files – the ASC, Anesthesia, Part B Drug, Physician, E & M, dialysis, imaging, tests, other procedures, DME and other carrier claims.

Source: CCW (derived)