Medicare PTA/PTB Managed Care Capitated Payment Amount — Total

SAS Name
MDCR_MC_PTA_PTB_CAPTD_SPEND

This variable is total capitated premium payment amount for Medicare Part A and Part B for the beneficiary during the year. Note that only Part A and B capitated payments are included (not Part D).

Comments

CMS and Medicare Advantage (MA) plans use the MARx System to exchange data files and reports between the Plans and CMS. The capitation payments provided to MA and Medicare Advantage Prescription Drug (MAPD) sponsors are calculated and paid monthly.

CCW calculates this variable as the sum of all the monthly Part A and Part B capitated premium payments. The dollar amounts reflect the final beneficiary payments and adjustments.

Values: $

Source: CMS Medicare Advantage Prescription Drug System (MARx) data (derived)