Inpatient (Fee-for-Service)

The Inpatient file contains final action fee-for-service claims data submitted by inpatient hospital providers for reimbursement of facility charges. The charge amount can be broken out for specific Revenue Center Codes, such as those for emergency room or emergency department charges.

This file includes:

  • diagnosis (ICD-9 diagnosis),
  • procedure (ICD-9 procedure code),
  • Medicare Severity Diagnosis Related Group (MS-DRG),
  • dates of service,
  • reimbursement amount,
  • hospital provider number, and
  • beneficiary demographic information

Additionally, this file includes revenue center information. The Revenue Center Codes provide details on charges, such as those for emergency room/emergency department charges.

Why do researchers request this file?

  • Clinical outcome studies that require diagnosis and procedure codes or length of hospital stay
  • Evaluations of cost, including charges and Medicare program payments
  • Analysis of specific service utilization by charge amount, such as emergency room use
  • Need to link IP data to other utilization file types and enrollment data

Emergency Room ER and Emergency Department facility costs, charges

Emergency room and Emergency department factility costs and facility charges are available in this file.  

CY 1999 - 2016

The 12-month run-off final action claims for 2017 will be available in the beginning of 2019.

Data File Classification