Dialysis Medicare Payments

SAS Name
DIALYS_MDCR_PMT

This variable is the total Medicare payments for Part B dialysis services (primarily the professional component since treatments are covered in hospital outpatient) for a given year. Dialysis claims are a subset of the claims, and a subset of procedures in the Part B Carrier data file.

Dialysis claims are defined as those with a line BETOS code (BETOS_CD) where the first 2 digits = 'P9'. 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.

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)