Updated research request forms and data security approval requirement effective 4/24/23
This variable is contained in the following files:
SAS Name
BENE_PRMRY_PYR_CD
The code indicating the type of payer who has primary responsibility for the payment of the Medicare beneficiary's claims related to the stay (if not Medicare).
| Code | Code value |
|---|---|
| A | Employer group health plan (EGHP) insurance for an aged beneficiary |
| B | EGHP insurance for an end-stage renal disease (ESRD) beneficiary |
| C | Conditional payment by Medicare; future reimbursement from the Public Health Service (PHS) expected |
| D | No fault automobile insurance |
| E | Worker's compensation (WC) |
| F | Public Health Service (PHS) or other Federal agency (other than VA) |
| G | Working disabled beneficiary under age 65 with a local government health plan (LGHP) |
| H | Black lung (BL) program |
| I | Department of Veteran's Affairs |
| L | Any liability insurance |
| M | Override EGHP — Medicare is primary payer |
| N | Override non-EGHP — Medicare is primary payer |
| Blank/missing | No other primary payer |
The presence of a primary payer code indicates that some other payer besides Medicare covered at least some portion of the charges.
This field comes from the primary payer code that is present on the first claim record included in the stay.
Source: NCH