CMS Fee Information

Fee Information for the CMS Data Files

Current Version Date: 
02/06/2017

Obtaining Fee Information

The current fees for Research Identifiable Files (RIF) and Limited Data Set (LDS) data are available on the ResDAC and Chronic Condition Warehouse (CCW) websites. Researchers interested in RIF data fees can review the CMS Fees for Research Files (below) or visit the cohort creator and cost estimate application tool.

 

Fee Information for the Research Identifiable Data Files

Factors that Affect Data Fees – Medicare and Medicaid

1)      Files Requested

CMS has numerous Medicare and Medicaid data files available for research use.  Researchers must request only the minimum data necessary to conduct their study and provide justification for the files and population requested. Researchers must select individual files they need for their study. Fees vary depending on the files requested.

2)      Standard Extract or Custom Cohort

2a) Standard Extract Cohorts

Researchers will need to determine if they are interested in a standard random sample of beneficiaries, such as the 5% or 20% sample, or a custom cohort. When a standard random sample of beneficiaries is selected, the requested output files will include all records of the requested file type for those beneficiaries in the sample. The standard sample files are ONLY available for Medicare data and not for Medicaid data.

2b)      Custom Cohorts

Size of Cohort

If a researcher decides to request data for a custom cohort, the fee for the data will depend on the number of beneficiaries in the cohort. Custom cohorts can be pulled based on (1) a known cohort such as study participants (by submitting patient identifiers), or (2) a search of one or more Medicare files based specific characteristics, such as state or clinical criteria, e.g., diagnosis codes. To estimate the size of the cohort for a Medicare data request, visit the cohort creator and cost estimate application tool which provides menu driven steps for determining an estimated cohort size. The tool can also provide the user with an estimated cost based on the estimated cohort size. Obtaining a formal cost estimate is the best way to be sure of the cohort size, which affects the fee.

 

Finder File Charges

If researchers submit their own finder files from a list of identifiers such as CCW beneficiary identifiers, Health Insurance Claim numbers, Social Security Numbers, or true Medicaid Statistical Information System (MSIS) identifiers, a finder file charge will not apply.

Researchers can also request to have a finder file created from the Medicare or Medicaid data itself. For example, a researcher could request to have all diabetics in a particular state pulled for a particular year. The cost of the finder file creation will depend on whether the criteria for the search is a simple or complex algorithm. A simple algorithm is defined as a search that only requires a single pass through the data. A complex algorithm is defined as a search that requires a multi-step approach (such as multiple passes through the data). Finder file creation is subject to a fee as identified in the fee list. Please see the examples in the Additional Resources at the end of this article.

3)      Years of Data

The RIF data are created on a calendar year basis and the fee for the data depends on the number of years purchased. Researchers will be charged for each year of data, for each file requested.

4)      Quarterly Data

Researchers can now request quarterly RIF data for Medicare fee-for-service (FFS) claims (Inpatient, Outpatient, Skilled Nursing Facility, Hospice, Home Health, Carrier, Durable Medical Equipment), as well as the Master Beneficiary summary file: base segment (A/B). Files will be for the current calendar year. The lag time for release from the end of the calendar quarter is approximately 4.5 months. For example, Quarter 1 2017 will be available by mid-August 2017.

The standard fees will apply to the initial quarter of data received for a new request. Each subsequent quarter, within the requested year of data, will be 50% of the data file’s standard fee. Changes to the cohort may change the fee for the file.

The claims maturity will be approximately 93% mature versus the annual file that is 99% mature. Quarterly files do not include a “refresh” of previously released quarters. When the year is final, researchers can request an annual file, priced at 50% of the yearly file fee for their cohort size.

Virtual Research Data Center (VRDC) Data Fees - Medicare and Medicaid

Fees for data that are requested through the VRDC are not based on the number of years requested or on the cohort size. Researchers who access data in the VRDC environment will be charged a standard Access Fee for the user to access the data in the secure environment. This fee covers the cost of the CMS onboarding, seat license, training, output review, and administrative costs. Researchers will also incur a Project Fee for initial projects. The project fee is a one-time fee that is data-specific, whereas the Access Fee is an annual cost. Once the initial year of access has expired, users in the VRDC may renew their access on an annual or quarterly basis. Users with existing projects must renew their Access Fee to continue working on their projects.

Researchers may also need to pay for additional space in the VRDC depending on the size of their data request. The first 500 GB of space are included in the Project Fee. Additional space can be purchased in 500 GB blocks. The cost for continued additional space will be charged during the renewal period, if applicable. File sizes for selected years of Medicare data are found in the article “File Sizes for 100% Research Identifiable Claims Files for years 2009-2011”

Existing VRDC seat holders may add additional projects to their user workspace for a fee. Any changes in the cohort that results in re-extracting data will be charged a fee. There is no charge to add additional years of data for the existing cohort.

Innovator Research Program

Data requested through the Innovator Research Program will be accessed through the VRDC. Therefore, the pricing structure will include an annually recurring user Access Fee, a one-time Project Fee, and additional space fees as needed.  However, the user Access and Project Fees differ between Innovator and non-Innovator requesters. The additional fees for the Innovator program covers the additional review board, additional output reviews and increased size of the download.  The specific pricing structure for Innovator requests can be found on Page 3 of the CMS Fees for Research Files found at the bottom of this article.

Limited Data Sets (LDS) Data Fees

Fees for the Medicare LDS data files are based on the number of years or quarters requested as well as the size of the files requested. LDS data are available as standard 5% or 100% national Medicare samples. Custom cohorts cannot be requested from the LDS data. The LDS Carrier and DME files are only available for the 5% Medicare population sample—the 100% LDS Carrier and DME files are not available. The Part D Event data, Medicaid data, and Assessment data are not available as LDS files. These files can only be requested as Research Identifiable Files.

 

Additional Resources: 
Article Number: 
123
This work was performed under CMS Contract Number HHSM-500-2005-00027I.
Related Data Request Processes: