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This variable is contained in the following files:
SAS Name
NCH_PRMRY_PYR_CD
The code, on an institutional claim, specifying a federal non-Medicare program or other source that has primary responsibility for the payment of the Medicare beneficiary's health insurance bills.
The presence of a primary payer code indicates that some other payer besides Medicare covered at least some portion of the charges.
| Code | Code value |
|---|---|
| A | Employer group health plan (EGHP) insurance for an aged beneficiary |
| B | EGHP insurance for an end-stage renal disease (ESRD) beneficiary |
| C | Conditional payment by Medicare; future reimbursement from the Public Health Service (PHS) expected |
| D | No fault automobile insurance |
| E | Workers' compensation (WC) |
| F | Public Health Service (PHS) or other Federal agency (other than VA) |
| G | Working disabled beneficiary under age 65 with a local government health plan (LGHP) |
| H | Black Lung (BL) program |
| I | Department of Veteran's Affairs |
| L | Any liability insurance |
| M | Override EGHP - Medicare is primary payer |
| N | Override non-EGHP - Medicare is primary payer |
| Blank/missing | No other primary payer |
Source: NCH