Operating Indirect Medical Education (IME) Amount

This variable is contained in the following files:

SAS Name

IME_OP_CLM_VAL_AMT

This is one component of the total amount that is payable on PPS claims, and reflects the IME (indirect medical education) payments for operating expenses (such as labor) for the claim.

There are two types of IME amounts that may be payable for many PPS claims; the other type of IME payment is for the IME capital amount (variable called CLM_PPS_CPTL_IME_AMT). Both operating and capital IME payments are components of the PPS, as well as numerous other factors.

Comments

Medicare payments are described in detail in a series of Medicare Payment Advisory Commission (MedPAC) documents called “Payment Basics” (see: http://www.medpac.gov/payment_basics.cfm).

Also in the Medicare Learning Network (MLN) “Payment System Fact Sheet Series” (see: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-NetworkMLN/MLNProducts/MLN-Publications.html).

Derivation Rules: If there is a value code '19' (i.e., in the Value Code File, if the VAL_CD='19') then this dollar amount (VAL_AMT) is used to populate this field.

Source: NCH