Data File Search
This file includes:Diagnosis codes (ICD diagnosis)Procedure codes (ICD procedure)Resouce Utilization Group codes (RUGs)Admission/discharge datesOrganization NPI number onlyNo payment variablesPart C/Medicare Advantage benefit package and contract numberEncounter records submitted to CMS by September, 2018, for dates of service in CY 2015.Special considerations:Many Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing...
Program:
Medicare
This file includes (variable highlights):diagnosis (ICD diagnosis) codesHCPCS codeRevenue center codes, dates, unit countsPart C Benefit Package and Contract numberOrganization NPI numberNo payment informationEncounter records submitted to CMS by September, 2018, for dates of service in CY 2015.Special considerations:Many Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing, dental, and/or health and wellness programs...
Program:
Medicare
This file includes (variable highlights):Admission, discharge datesdiagnosis (ICD diagnosis) codesprocedure (ICD procedure) codesdiagnostic related group (DRG) codespatient discharge status codeorganization NPIPart C/Medicare Advantage benefit package and contract numberRevenue center codes, dates, unit countsNo payment variables are availableEncounter records submitted to CMS by September, 2018, for dates of service in CY 2015.Special considerations:Many Medicare Advantage Plans offer extra coverage in...
Program:
Medicare
This file includes (variable highlights):Part C Benefit Package and Contract numberdiagnosis (ICD diagnosis) codesHCPCS codeRevenue center codes, dates, unit countsOrganization NPINPI for line rendering physicianPatient discharge status codeNo payment variablesEncounter records submitted to CMS by September, 2018, for dates of service in CY 2015.Special considerations:Many Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision,...
Program:
Medicare
This file includes (variable highlights):Part C Benefit Package and Contract numberdiagnosis (ICD diagnosis)HCPCS codeOrganization NPINPI for line supplierDate of service (line date)Encounter records submitted to CMS by September, 2018, for dates of service in CY 2015.Special considerations:Many Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing, dental, and/or health and wellness programs). Encounter data will...
Program:
Medicare
This file includes (variable highlights):Part C Benefit Package and Contract numberdiagnosis (ICD diagnosis)HCPCS codeDate of service (line date)NPI for line rendering physicianNo payment informationEncounter records submitted to CMS by September, 2018, for dates of service in CY 2015.Special considerations:Many Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing, dental, and/or health and wellness programs). ...
Program:
Medicare
The PY14 Risk Score Files includes six segments: a base file, four files with outputs from Part C models and one for Part D model outputs. All files can be linked to other CCW files via the Bene_ID.What does this file include? (variable highlights)PY14 Base file:Part C monthly risk payment scoresPart C monthly model segment codesPart D model risk payment scoresPart D monthly model segment codesPart C monthly institutional indicatorsPart C community and institutional non-monthly model payment scoresPart D...
Program:
Medicare
What does this file include? (variable highlights)Practice IdentifierQuality and Resource Use Report (QRUR) informationVM informationBenchmark informationSpecial considerationsData documentation is specific to each performance year.This RIF includes thousands of records with hundreds of variables.Can be linked to provider NPI in the VM NPI-Practice-Level RIFTwo additional VM program RIFs are available:VM NPI-Practice-Level RIFVM Beneficiary-Level File RIF
Program:
Medicare
What does this file include? (variable highlights)Beneficiary identifiersPractice identifier for the practice to which the beneficiary was attributedNumber and percent of primary care services provided to the beneficiary that were billed by the practiceHCC percentile risk scoreSpecial considerationsData documentation is specific to each performance year.This RIF can be linked to any other CMS file that includes the Bene ID.Two additional VM program RIFs are available:VM Practice-Level RIFVM NPI-Practice-...
Program:
Medicare
What does this file include? (variable highlights)quarterly assignmentdate of birthdate of deathgenderracemonthly Medicare eligibility informationencrypted beneficiary identifier link to the Shared Savings Program Provider-Level RIFSpecial considerationsThis file can be linked to any other CMS file that includes the Bene ID.Shared Savings Program RIFs do not include Pioneer ACO, Next Generation ACO or Comprehensive End Stage Renal Disease Care (CEC) data.The Shared Savings Program Beneficiary-Level RIF was...
Program:
Medicare
What does this file include? (variable highlights)ACO name and start dateNational Provider Identifier (NPI)/nameTaxpayer Identification Number (TIN)/nameCMS Certification Number (CCN)facility type - institutionspractice type (specialty) - individualscounty primarily servicedSpecial considerationsShared Savings Program RIFs do not include Pioneer ACO, Next Generation ACO or Comprehensive End Stage Renal Disease Care (CEC) data.All technical questions related to the Shared Savings Program should be directed to...
Program:
Medicare
What does this file include? (variable highlights)Provider filePioneer ACO IDTax identification numberProvider specialty code Beneficiary fileBene IDPioneer ACO IDAggregated expenditures and claim countsSettlement filePioneer ACO IDBeneficiary countsPerformance year expenditures and savingsSpecial considerationsEach file needs to be specified separately on a data request.Only the Pioneer ACO Beneficiary file can be linked to other CMS data via the Bene ID.
Program:
Medicare
What does this file include? (variable highlights)The MD-PPAS has been updated to version 2.3 from version 2.2 to reflect the following changes: The data now include variables on the percentage of a provider’s line items that are performed in eight place-of-service categories.The data use a corrected form of the zip-code-to-CBSA crosswalk to assign providers to CBSA based on the zip code reported on their submitted claims. This correction resulted in a small percentage of providers that exist in both version...
Program:
Medicare
What does this file include? (variable highlights)Beneficiary level recordsSNP enrollmentBody Mass Index (BMI)Disease screening indicatorsChronic condition treatment indicatorsCounts of specific procedures
Program:
Medicare
What does this file include? (variable highlights)Diagnosis codes (ICD diagnosis)Procedure codes (ICD procedure)Resource Utilization Group codes (RUGs)Admission/discharge datesOrganization NPI number onlyNo payment variablesPart C/Medicare Advantage benefit package and contract numberSpecial considerationsMany Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing, dental, and/or health and wellness programs). Encounter...
Program:
Medicare
What does this file include? (variable highlights)diagnosis (ICD diagnosis) codesHCPCS codeRevenue center codes, dates, unit countsPart C Benefit Package and Contract numberOrganization NPI numberNo payment informationSpecial considerationsMany Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing, dental, and/or health and wellness programs). Encounter data will include records for these additional items and services...
Program:
Medicare
What does this file include? (variable highlights)Admission, discharge datesdiagnosis (ICD diagnosis) codesprocedure (ICD procedure) codesdiagnostic related group (DRG) codespatient discharge status codeorganization NPIPart C/Medicare Advantage benefit package and contract numberRevenue center codes, dates, unit countsNo payment variables are availableSpecial considerationsMany Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (vision,...
Program:
Medicare
What does this file include? (variable highlights)Part C Benefit Package and Contract numberdiagnosis (ICD diagnosis) codesHCPCS codeRevenue center codes, dates, unit countsOrganization NPINPI for line rendering physicianPatient discharge status codeNo payment variablesSpecial considerationsMany Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing, dental, and/or health and wellness programs). Encounter data will...
Program:
Medicare
What does this file include? (variable highlights)Part C Benefit Package and Contract numberdiagnosis (ICD diagnosis)HCPCS codeOrganization NPINPI for line supplierDate of service (line date)Special considerationsMany Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing, dental, and/or health and wellness programs). Encounter data will include records for these additional items and services provided under the plan.This...
Program:
Medicare
What does this file include? (variable highlights)Part C Benefit Package and Contract numberdiagnosis (ICD diagnosis)HCPCS codeDate of service (line date)NPI for line rendering physicianNo payment informationThis file is no longer available since the final version is now available for request.
Program:
Medicare
What does this file include? (variable highlights)Resource Utilization Group (RUG) codeClinical status measuresPhysical functioning assessmentPsychological status measuresPsycho-social functioning measure
Program:
Medicare, Medicaid
What does this file include? (variable highlights)Resource Utilization Group (RUG) codeClinical status measuresPhysical functioning assessmentPsychological status measuresPsycho-social functioning measure
Program:
Medicare, Medicaid
What does this file include? (variable highlights)Resource Utilization Group (RUG) codeClinical status measuresPhysical functioning assessmentPsychological status measuresPsycho-social functioning measureEnd-of-life care decisions
Program:
Medicare, Medicaid
What does this file include? (variable highlights)Resource Utilization Group (RUG) codeClinical status measuresPhysical functioning assessmentPsychological status measuresPsycho-social functioning measureEnd-of-life care decisions
Program:
Medicare, Medicaid
What does this file include? (variable highlights)HIPPS codesocio-demographic variablesinformation on patient home environment and informal caregivershealth status, including diagnosis codesfunctional statuspsychosocial statushealth service utilizationemergent carehospital admissionSpecial considerationsThe Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) suspended required completion for non-Medicare and non-Medicaid patients.
Program:
Medicare, Medicaid