Medicare Part C Contract Number

This variable is contained in the following files:

Encounter Skilled Nursing Facility Encounter Outpatient Encounter Inpatient

SAS Name

CNTRCT_NUM

This variable is the unique identification for a managed care organization (MCO) enabling the entity to provide coverage to eligible Medicare beneficiaries.

Comments

The first character of the contract ID is a letter that indicates the type of plan. For local managed care contracts, it begins with 'H' or '9'; for regional managed care contracts, it begins with 'R'; for prescription drug plans (PDPs), it begins with 'S'; for fallback contracts, it begins with 'F', for Employer- Direct PDP and Employer-Direct PFFS it begins with 'E'. The remaining 4 digits are numeric.

You need to know both the contract number and plan benefit package number (CNTRCT_PBP_NUM) in order to identify the specific plan in which a beneficiary was enrolled.

Source: Medicare Advantage Organizations (MAOs)