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This variable is contained in the following files:
SAS Name
OUD_MAT_MEDICARE
This variable indicates whether a beneficiary met the criteria for the Use of MedicationAssisted Treatment (MAT) as of the end of the calendar year.
| Code | Code value |
|---|---|
| 0 | Beneficiary did not meet claims criteria or have sufficient fee-for-service (FFS) coverage |
| 1 | Beneficiary met claims criteria but did not have sufficient FFS coverage |
| 2 | Beneficiary did not meet claims criteria but had sufficient FFS coverage |
| 3 | Beneficiary met claims criteria and had sufficient FFS coverage |
The condition variable requires beneficiaries to satisfy both claims criteria (a minimum number/type of Medicare claims that have the proper codes and occurred within a specified time period) and coverage criteria (Medicare FFS Part A and Part B coverage during the entire specified time period).
For use of Medication-Assisted Treatment (MAT), beneficiaries must have one or more drug claim (Medicare Part B, Medicare Part D, and/or Medicaid) with an NDC (national drug code) for opioid-MAT or one or more non-drug claim (Medicare Part B or Medicaid non-drug claim) with a HCPCs code during the two year period.
You can find more detailed information on the criteria on the CCW website: https://www.ccwdata.org/web/guest/condition-categories
Source: CCW (derived)