NCH Primary Payer Code (if not Medicare)

This variable is contained in the following files:

Original Medicare (Fee-for-Service) Home Health Agency Original Medicare (Fee-for-Service) Hospice Original Medicare (Fee-for-Service) Inpatient Original Medicare (Fee-for-Service) Outpatient Original Medicare (Fee-for-Service) Skilled Nursing Facility

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.

Comments

Source: NCH

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