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Therapy Amount Applied to Limit

CLM_LINE_CARR_PSYCH_OT_LMT_AMT

For type of service psychiatric, occupational therapy, or physical therapy, the amount of allowed charges applied toward the limit cap for this line item service on the noninstitutional claim. [NCH]

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath
ExplanationOfBenefit.item.adjudication.where(
category.coding.where(
system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication'
) and
category.coding.where(
code = 'CLM_LINE_CARR_PSYCH_OT_LMT_AMT'
)
).amount.value
Coverage / Claim Type
  • Carrier
Source View
V2_MDCR_CLM_LINE_PRFNL
Source Column
CLM_LINE_CARR_PSYCH_OT_LMT_AMT
Sources
  • MCS
  • NCH
Profiles
  • CMS

Example

11.12
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