Outpatient (Fee-for-Service)

The Outpatient file contains final action, fee-for-service claims data submitted by institutional outpatient providers. Examples of institutional outpatient providers include hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, comprehensive outpatient rehabilitation facilities, and community mental health centers.

This file includes:

  • diagnosis (ICD-9 diagnosis)
  • Healthcare Common Procedure Coding System (HCPCS) codes,
  • dates of service,
  • reimbursement amount,
  • outpatient provider number,
  • revenue center codes, and
  • beneficiary demographic information
CY 1999 - 2016

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

Data File Classification