PAYER TYPE LIST PAYER PAYER TYPE TYPE CODE PAYER …

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Division of Health Care Finance and Policy CMR Submission of Hospital Case Mix and Charge Data PAYER Type & PAYER Source Code List - Effective Date 10/01/09 1 PAYER TYPE LIST PAYER TYPE CODE PAYER TYPE DEFINITION PAYER TYPE ABBREVIATION 1 Self Pay SP 2 Worker's Compensation WC 3 Medicare MCR F Medicare Managed Care MCR-MC 4 Medicaid 4 B Medicaid Managed Care MCD-MC 5 Other Government Payment GOV 6 Blue Cross BCBS C Blue Cross Managed Care BCBS-MC 7 Commercial Insurance COM D Commercial Managed Care COM-MC 8 HMO HMO 9 Other Free Care (Charity Care) FC 0 Other Non-Managed Care Plans OTH E PPO and Other Managed Care Plans Not Els

Payer Type & Payer Source Code List - Effective Date 10/01/09 7 174 Aetna Health Inc. - Quality POS 8 HMO 175 Aetna Health, Inc. - HMO 8 HMO 176 Carelink (CIGNA & Tufts) 7 COM 177 Chesapeake Life Insurance Company 7 COM 178 Children's Medical Security Plan (CMSP) 5 GOV 179 First Health Life and Health Insurance Company 7 COM

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