Carrier LDS KnowledgeBase Articles

Difference Between Line Payment Amounts in Carrier File

Article Number: 
167

The carrier claims data will contain two payment amount fields at the line item level that appear to be very similar. These variables are the "Line NCH Payment Amount" (LINEPMT) and the "Line Provider Payment Amount" (LPRVPMT). The LINEPMT field is the amount that Medicare is responsible for reimbursing for the line item. The LPRVPMT is the amount that

Medicare Provider Types: Ambulatory Surgical Centers (ASCs)

Article Number: 
105

Background: Although ambulatory surgical centers (ASCs) perform surgeries that could also be performed in a hospital outpatient department, how they bill Medicare for these surgeries and the amount they are reimbursed for these surgeries differs from those that are performed in a hospital outpatient department.

 

There are two types of providers that are allowed to bill Medicare for outpatient-based surgeries: