Patient Residence Code
This variable indicates where the beneficiary lived when the prescription was filled, as reported on the PDE record.
CMS requires Part D plans to maintain pharmacy networks that are sufficient to ensure convenient access to Medicare beneficiaries – including retail, home infusion, and long-term care pharmacies. This variable is designed to help CMS and plan sponsors monitor beneficiary access to a range of "in-network" pharmacies.
This variable was new in 2013 and required for all PDEs beginning on February 28, 2013.
Note that the location indicated by this variable may not correspond with other information regarding beneficiary residence – such as Medicare Part A or B claims or Minimum Data Set (MDS) assessment information.
This variable is coded, and will contain one of the following values.
| Value | Description |
|---|---|
00 |
Not specified, other patient residence not identified below |
01 |
Home |
02 |
Skilled Nursing Facility |
03 |
Nursing facility (long-term care facility) |
04 |
Assisted living facility |
05 |
Custodial Care Facility (residential but not medical care) |
06 |
Group home (e.g., congregate residential foster care) |
07 |
Inpatient Psychiatric Facility |
08 |
Psychiatric Facility – Partial Hospitalization |
09 |
Intermediate care facility for the mentally retarded (ICF/MR) |
10 |
Residential Substance Abuse Treatment Facility |
11 |
Hospice |
12 |
Psychiatric Residential Treatment Facility |
13 |
Comprehensive Inpatient Rehabilitation Facility |
14 |
Homeless Shelter |
15 |
Correctional Institution |
Some additional information on this variable: