The Medicare Outpatient (Encounter) file contains Medicare Advantage plan paid records from a variety of outpatient providers. Examples of institutional outpatient providers include hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, comprehensive outpatient rehabilitation facilities, Federally Qualified Health Centers and community mental health centers.
What does this file include? (variable highlights)
- diagnosis (ICD diagnosis) codes
- HCPCS code
- Revenue center codes, dates, unit counts
- Part C Benefit Package and Contract number
- Organization NPI number
- No payment information
- 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 include records for these additional items and services provided under the plan.