Updated research request forms and data security approval requirement effective 4/24/23
Knowledgebase
Introductory
Articles
CMS offers files from aggregate data to individual person level data. This article describes the differences between the aggregate, public use files, the limited data sets,…
This article describes the Federal Regulations that govern the release of CMS data for research.
The purpose of this article is to identify 1) common strengths of Medicare and Medicaid administrative data and 2) broad limitations for researchers to consider when…
Popular
Articles
This article provides guidance on how to identify hospital emergency room claims from the Medicare files.
Providers that bill Medicare use codes for patient diagnoses and codes for care, equipment, and medications provided. This articles provides resources to identify the codes…
To describe the CMS cell size suppression policy and provide examples of common scenarios and possible options.
Featured Article
There are many different provider variables in the Medicare Fee-for-Service (FFS) Claims and Encounter data. Researchers are often interested in the performing NPI and/or the facility CCN or organizational NPI, but other variables are sometimes…
This article describes three variable groups that can be used to identify managed care enrollment for Medicaid beneficiaries. Codes for the variables are also given that identify beneficiaries who received their comprehensive medical care under the Fee-For-Service (FFS) payment system.
This article provides resources for the assessment of the quantity and quality of managed care organization (MCO) encounter data in the Medicaid Analytic eXtract (MAX) files.
The beneficiary eligibility and enrollment files have changed in content and name over the years. It is important to understand the timing of these changes and the unique features of each file if you are using older files or see them referenced in articles.
Researchers who request the Minimum Data Set (MDS) from CMS will need to determine whether they would like data based on Target Date or Submission Date. This article provides definitions for Target and Submission dates and examples for when each selection is useful.
Values that are "missing" in the Minimum Data Set (MDS) nursing home assessment can be represented by several different symbols. While all of these symbols represent that a value is "missing," the specific symbol indicates the specific reason why the value is missing.
The purpose of this article is to provide CMS’s definition of uncompensated care, the years collected, and location in the Medicare hospital cost report forms.
This article outlines the provider identification numbers that are available in the MAX files and options for linking to the Medicare Provider Number.
This article describes the structure of the Medicare cost reports and provides instructions for identifying specific data elements for specific facilities. While the examples and screenshots provided below are specific to the hospital cost reports, the discussion on file structure and logic used for identifying specific variables are applicable to any facility cost report.
The purpose of this knowledge base article is to 1) present an overview of International Classification of Disease (ICD) codes and versions available, 2) describe where researchers can find these codes in the Medicare claims, and 3) understand how ICD codes appear in the data.
This article has three goals: (1) to describe missing patterns on pain variables; (2) to describe the difference between real missing and skip patterns; (3) to describe which assessments should be used for calculating pain measures. This information is most relevant for researchers who work on either creating their own pain measures or constructing CMS quality measures. The new MDS 3.0 requires nursing home staff to interview residents regarding health conditions, such as pain, mood and cognitive function through…
Providers that bill Medicare use codes for patient diagnoses and codes for care, equipment, and medications provided. This articles provides resources to identify the codes used in Medicare claims files.
Researchers and data users who are working with CMS files may need to map zip code information to CMS carriers and localities. This article describes where to find current and historical versions of the file.