["Patient Characteristic, Payer": "Payer Type"]
Performance/Reporting Period
2028
Value Set Description from VSAC
Clinical Focus: Categories of types of health care payer entities as defined by the Centers for Disease Control and Prevention National Center for Health Statistics Source of Payment Codes.
Data Element Scope: Concepts intended to represent categories of insurance (payer) types.
Inclusion Criteria: Codes representing high level categories of insurance (payer) types
Exclusion Criteria: Codes representing, subdivisions of insurance categories and or specific private insurance companies
Data Element Scope: Concepts intended to represent categories of insurance (payer) types.
Inclusion Criteria: Codes representing high level categories of insurance (payer) types
Exclusion Criteria: Codes representing, subdivisions of insurance categories and or specific private insurance companies
Constrained to codes in the Payer Type value set (2.16.840.1.114222.4.11.3591)
QDM Datatype and Definition
"Patient Characteristic, Payer"
Data elements that meet criteria using this datatype should document that the patient has one or more of the payers indicated by the QDM category and its corresponding value set.
Timing:
The relevantPeriod addresses:
- startTime – the first day of insurance coverage with the referenced payer.
- stopTime – the last day of insurance coverage with the referenced payer.
eCQMs using this data element:
Last Updated: Jul 28, 2026