Line Beneficiary Coinsurance Amount

This variable is contained in the following files:

Carrier (Fee-for-Service) Durable Medical Equipment (Fee-for-Service)

SAS Name

LINE_COINSRNC_AMT

The beneficiary coinsurance liability amount for this line item service on the non-institutional claim.

This variable is the beneficiary’s liability for coinsurance for the service on the line item record.

Beneficiaries only face coinsurance once they have satisfied Part B’s annual deductible, which applies to both institutional (e.g., Hospital Outpatient) and non-institutional (e.g., Carrier and DME) services.

For most Part B services, coinsurance equals 20 percent of the allowed amount.

Comments

Medicare payments are described in detail in a series called the Medicare Learning Network (MLN) “Payment System Fact Sheet Series” (see the list of MLN publications at: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-NetworkMLN/MLNProducts/MLN-Publications.html).

Source: NCH