Medicare Advantage Payer Code Changes – Effective with Q1-2025 Data Submissions
Beginning with Q1-2025 discharge data submissions there will be changes in reporting Medicare Advantage payer classification codes.
There is a need to analyze more granular Medicare Advantage plans that have been identified as the most utilized Medicare Advantage payers across the state. Currently, all Tennessee hospitals report all Medicare Advantage plans in patient discharge records using payer “K.” Additional Medicare Advantage payer codes, K1 – K7, have been added to the payer classification categories.
Beginning with your Q1-2025 discharge data submissions, we ask that you make changes to the way you map your Medicare Advantage payer classification codes as described below. This change applies to primary, secondary and tertiary payer name codes (additional details about these data fields can be found in the 2020 HDDS manual on pages 65, 68 and 71).
The Tennessee Department of Health (TDH) emailed this notice on November 22, 2024. The notice can be found here. Please report the data to THA/HIDINet using the payer classification codes listed above beginning with your Q1-2025 data submissions which are due by May 30, 2025.