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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