NCH Primary Payer Code (if not Medicare)
The code, on an institutional claim, specifying a federal non-Medicare program or other source that has primary responsibility for the payment of the Medicare beneficiary's health insurance bills.
The presence of a primary payer code indicates that some other payer besides Medicare covered at least some portion of the charges.
This variable is coded, and will contain one of the following values.
| Value | Description |
|---|---|
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 |
Some additional information on this variable: