Reminder: DUA and VRDC access needs to be extended or renewed annually. Read more.
This variable is contained in the following files:
SAS Name
OIP_BENE_PMT
This variable is the sum of Medicare coinsurance and deductible payments in the nonacute inpatient hospital setting for the year. The total “other” inpatient (OIP) beneficiary payments are calculated as the sum of NCH_BENE_IP_DDCTBL_AMT and NCH_BENE_PTA_COINSRNC_LBLTY_AM for all relevant claims where the CLM_PMT_AMT >= 0.
These OIP claims are a subset of the claims in the IP data file consisting of data from IP settings such as long- term care hospitals, inpatient psychiatric facilities, inpatient rehabilitation facilities, and other types of IP facilities such as children’s hospitals or cancer centers.
There are 2 cost/use categories from the IP data files: Acute and the OIP.
Costs that beneficiaries are liable for are described in detail on the Medicare.gov website. There is a CMS publication called "Your Medicare Benefits", which explains the deductibles and coinsurance amounts. Medicare payments are described in detail in a series of Medicare Payment Advisory Commission (MedPAC) documents called “Payment Basics” (see: http://www.medpac.gov/-documents-/payment-basics).
Also in the Medicare Learning Network (MLN) “Payment System Fact Sheet Series” (see the list of MLN publications at: http://www.cms.gov/Outreach-andEducation/Medicare-Learning-Network-MLN/MLNProducts/MLN- Publications.html)
Source: CCW (derived)