Claim Next Generation (NG) Accountable Care Organization (ACO) Indicator Code – Population-Based Payment (PBP)

SAS Name
CLM_NEXT_GNRTN_ACO_IND_CD

The field identifies the claims that qualify for specific claims processing edits related to benefit enhancement through the Next Generation (NG) Accountable Care Organization (ACO).

Code Code value
0 Base record (no enhancements)
1 Population Based Payments (PBP)
2 Telehealth
3 Post Discharge Home Health Visits
4 3-Day SNF Waiver
5 Capitation