Part B Physician Medicare Payments

SAS Name

This variable is the total Medicare payments for the part B physician office services (PHYS) for a given year. Physician office claims are a subset of the claims in the Part B Carrier and DME data files, and a subset of physician evaluation and management claims (note that E&M are tabulated separately in this data file).

The physician claims are defined as those with a line BETOS code (BETOS_CD) where the first 3 digits = M1A or M1B (note that all other BETOS_CD that begin with "M" are categorized as other evaluation & management services in this file – see EM_MDCR_PMT). The total Medicare payments are calculated as the sum of LINE_NCH_PMT_AMT where the LINE_PRCSG_IND_CD was ('A','R', or 'S') - for all relevant lines


There are 11 cost/use categories from the Carrier Part B and DME data files – the ASC, Anesthesia, Part B Drug, Physician, E & M, dialysis, imaging, tests, other procedures, DME and other carrier claims.

Source: CCW (derived)