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.
|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|