FPAR Pirmary Insurance Classification value set

Copyright Statement: TBD

This value set includes codes from the following code systems:

• Include these codes as defined in SOP (Source of Payment Typology)

  Code	Display
  1	MEDICARE
  11	Medicare (Managed Care)
  111	Medicare HMO
  112	Medicare PPO
  113	Medicare POS
  119	Medicare Managed Care Other
  12	Medicare (Non-managed Care)
  121	Medicare FFS
  122	Medicare Drug Benefit
  123	Medicare Medical Savings Account (MSA)
  129	Medicare Non-managed Care Other
  13	Medicare Hospice
  14	Dual Eligibility Medicare/Medicaid Organization
  19	Medicare Other
  191	Medicare Pharmacy Benefit Manager
  2	MEDICAID
  21	Medicaid (Managed Care)
  211	Medicaid HMO
  212	Medicaid PPO
  213	Medicaid PCCM (Primary Care Case Management)
  219	Medicaid Managed Care Other
  22	Medicaid (Non-managed Care Plan)
  23	Medicaid/SCHIP
  25	Medicaid - Out of State
  26	Medicaid -- Long Term Care
  29	Medicaid Other
  291	Medicaid Pharmacy Benefit Manager
  299	Medicaid - Dental
  3	OTHER GOVERNMENT (Federal/State/Local) (excluding Department of Corrections)
  31	Department of Defense
  311	TRICARE (CHAMPUS)
  3111	TRICARE Prime--HMO
  3112	TRICARE Extra--PPO
  3113	TRICARE Standard - Fee For Service
  3114	TRICARE For Life--Medicare Supplement
  3115	TRICARE Reserve Select
  3116	Uniformed Services Family Health Plan (USFHP) -- HMO
  3119	Department of Defense - (other)
  312	Military Treatment Facility
  3121	Enrolled Prime--HMO
  3122	Non-enrolled Space Available
  3123	TRICARE For Life (TFL)
  313	Dental --Stand Alone
  32	Department of Veterans Affairs
  321	Veteran care--Care provided to Veterans
  3211	Direct Care--Care provided in VA facilities
  3212	Indirect Care--Care provided outside VA facilities
  32121	Fee Basis
  32122	Foreign Fee/Foreign Medical Program (FMP)
  32123	Contract Nursing Home/Community Nursing Home
  32124	State Veterans Home
  32125	Sharing Agreements
  32126	Other Federal Agency
  32127	Dental Care
  32128	Vision Care
  322	Non-veteran care
  3221	Civilian Health and Medical Program for the VA (CHAMPVA)
  3222	Spina Bifida Health Care Program (SB)
  3223	Children of Women Vietnam Veterans (CWVV)
  3229	Other non-veteran care
  33	Indian Health Service or Tribe
  331	Indian Health Service -- Regular
  332	Indian Health Service -- Contract
  333	Indian Health Service - Managed Care
  334	Indian Tribe - Sponsored Coverage
  34	HRSA Program
  341	Title V (MCH Block Grant)
  342	Migrant Health Program
  343	Ryan White Act
  349	Other
  35	Black Lung
  36	State Government
  361	State SCHIP program (codes for individual states)
  362	Specific state programs (list/ local code)
  369	State, not otherwise specified (other state)
  37	Local Government
  371	Local - Managed care
  3711	HMO
  3712	PPO
  3713	POS
  372	FFS/Indemnity
  379	Local, not otherwise specified (other local, county)
  38	Other Government (Federal, State, Local not specified)
  381	Federal, State, Local not specified managed care
  3811	Federal, State, Local not specified - HMO
  3812	Federal, State, Local not specified - PPO
  3813	Federal, State, Local not specified - POS
  3819	Federal, State, Local not specified - not specified managed care
  382	Federal, State, Local not specified - FFS
  389	Federal, State, Local not specified - Other
  39	Other Federal
  391	Federal Employee Health Plan - Use when known
  4	DEPARTMENTS OF CORRECTIONS
  41	Corrections Federal
  42	Corrections State
  43	Corrections Local
  44	Corrections Unknown Level
  5	PRIVATE HEALTH INSURANCE
  51	Managed Care (Private)
  511	Commercial Managed Care - HMO
  512	Commercial Managed Care - PPO
  513	Commercial Managed Care - POS
  514	Exclusive Provider Organization
  515	Gatekeeper PPO (GPPO)
  516	Commercial Managed Care - Pharmacy Benefit Manager
  517	Commercial Managed Care - Dental
  519	Managed Care, Other (non HMO)
  52	Private Health Insurance - Indemnity
  521	Commercial Indemnity
  522	Self-insured (ERISA) Administrative Services Only (ASO) plan
  523	Medicare supplemental policy (as second payer)
  524	Indemnity Insurance - Dental
  529	Private health insurance--other commercial Indemnity
  53	Managed Care (private) or private health insurance (indemnity), not otherwise specified
  54	Organized Delivery System
  55	Small Employer Purchasing Group
  56	Specialized Stand Alone Plan
  561	Dental
  562	Vision
  59	Other Private Insurance
  6	BLUE CROSS/BLUE SHIELD
  61	BC Managed Care
  611	BC Managed Care -- HMO
  612	BC Managed Care -- PPO
  613	BC Managed Care -- POS
  614	BC Managed Care - Dental
  619	BC Managed Care -- Other
  62	BC Insurance Indemnity
  621	BC Indemnity
  622	BC Self-insured (ERISA) Administrative Services Only (ASO)Plan
  623	BC Medicare Supplemental Plan
  629	BC Indemnity - Dental
  7	MANAGED CARE, UNSPECIFIED (to be used only if one can't distinguish public from private)
  71	HMO
  72	PPO
  73	POS
  79	Other Managed Care
  8	NO PAYMENT from an Organization/Agency/Program/Private Payer Listed
  81	Self-pay (Includes applicants for insurance and Medicaid applicants)
  82	No Charge
  821	Charity
  822	Professional Courtesy
  823	Research/Clinical Trial
  83	Refusal to Pay/Bad Debt
  84	Hill Burton Free Care
  85	Research/Donor
  89	No Payment, Other
  9	MISCELLANEOUS/OTHER
  91	Foreign National
  92	Other (Non-government)
  93	Disability Insurance
  94	Long-term Care Insurance
  95	Worker's Compensation
  951	Worker's Comp HMO
  953	Worker's Comp Fee-for-Service
  954	Worker's Comp Other Managed Care
  959	Worker's Comp, Other unspecified
  96	Auto Insurance (includes no fault)
  97	Legal Liability / Liability Insurance
  98	Other specified but not otherwise classifiable (includes Hospice - Unspecified plan)
  99	No Typology Code available for payment source
  9999	Unavailable / No Payer Specified / Blank