Tests Beneficiary Payments

SAS Name
TEST_BENE_PMT

This variable is the sum of coinsurance and deductible payments for part B tests for a given year. The total Beneficiary payments are calculated as the sum of LINE_COINSRNC_AMT + LINE_BENE_PTB_DDCTBL_AMT for the relevant lines.

Claims for tests are a subset of the claims in the Part B Carrier data file. These claims are defined as those with a line BETOS code (BETOS_CD) where the first digit =T.

Comments

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)