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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

bluebutton.cms.gov

official website of the U.S. Department of Health and Human Services and the Centers for Medicare & Medicaid Services.

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