Specifications Manual for Joint Commission National Quality Measures (v2022B2)
Posted: 09/06/2022
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Release Notes:
Data Element
Version 2022B2

Name:Payment Source
Collected For: All Records, Optional for HBIPS-2 and HBIPS-3
Definition:The source of payment for this episode of care.
Question:What is the patient's source of payment for this episode of care?
Allowable Values:

1 Source of payment is Medicare.

2 Source of payment is NonMedicare.
Notes for Abstraction:
  • If Medicare is listed as the primary, secondary, tertiary, or even lower down on the list or payers, select "1".
  • If the patient has Medicaid only or Medicaid and another insurance type, other than Medicare, select "2". If the patient has Medicaid and Medicare, select "1".
  • If the patient is an Undocumented Alien or Illegal immigrant select "1". Undocumented Alien: Section 1011 of the Medicare Modernization Act of 2003 allows for reimbursement for services rendered to patients who are:
    • Undocumented aliens
    • Aliens paroled into a United States port of entry for the purpose of receiving eligible services
    • Mexican citizens permitted to enter the United States for not more than 72 hours under the authority of a laser visa, issued in accordance with the requirements of regulations prescribed under the Immigration and Nationality Act
Suggested Data Sources:
  • Face sheet
  • UB-04
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
Medicare includes, but is not limited to:
  • Black Lung
  • End Stage Renal Disease (ESRD)
  • Medicare Fee for Service (includes DRG or PPS)
  • Medicare HMO/Medicare Advantage
  • Medicare Part A, B, C, D, F, G, K, L, M, and N
  • Medicare Secondary Payer
  • Railroad Retirement Board (RRB)

  • None

Payment Source
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Specifications Manual for Joint Commission National Quality Measures (v2022B2)
Discharges 10-01-22 through 12-31-22 (4Q22)


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