» Pricing Information

Pricing Information for the CMS Data Files

Current Version Date: 
06/12/2015

Obtaining Cost Information

The current prices 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 prices can review the CMS Price List for Research Files (below) or visit the cohort creator and cost estimate application tool.

Pricing Information for the Research Identifiable Data Files

Factors that Affect Data Prices – Medicare and Medicaid

1)      Files Requested

CMS has numerous Medicare and Medicaid data files available for use by researchers. Descriptions of the various files can be found on the ResDAC website. Researchers must determine which individual files they require for their study. Prices vary depending on the files requested.

2)      Standard Extract or Custom Cohort

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. Note that the standard sample files are ONLY available for Medicare data and not for Medicaid data. In some cases, the 100% files may be requested. Researchers must request only the minimum data necessary to conduct their study so strong justification is required for both the 20% or 100% files. The 100% data are not available for the Carrier and Part D event data.

3)      Custom Cohorts

Size of Cohort

If a researcher decides to request data for a custom cohort, the price of 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. Keep in mind that obtaining a formal cost estimate is the best way to be sure of the cohort size which affects the price.

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 (Medicaid) 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 in these cases 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 fee as identified in the price list.  Please see the examples near the end of the price list.

4)      Years of Data

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

5)      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 5.5 months. For example, Quarter 1 2015 will be available by mid-August 2015.

The standard pricing rate will apply to the initial quarter of data received for a new request. Each subsequent quarter will be at 50% of the data file cost. Eg: Year 1 price per quarter: 100% + 50% + 50% + 50%; Year 2 (and each subsequent year) price per quarter: 50% + 50% + 50% + 50%.

Changes to the cohort may change the price of the file.

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

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

Data that are requested through the VRDC are not priced 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 and additional new projects which require a data extract. 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. User 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.

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.

Limited Data Sets (LDS) Data Pricing

LDS data files are priced based on the number of years requested as well as the size of the files requested. LDS data are available as standard 5% or 100% national samples. Custom cohorts cannot be requested from the LDS data. The LDS Carrier and DME files are only available as for the 5% Medicare population sample—the 100% LDS Carrier and DME files are not available. Please note that 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.

Public Use Files (PUF) Data Pricing

 PUF data files vary in price based on the file type. Many are available free of charge and can be downloaded directly from the CMS website. Other PUF data files can be requested directly from CMS for a nominal fee.

The following CMS PUF data are available as free downloadable files:

Cost Reports

Medicare Claims Synthetic Public Use Files (SynPUFs)

Medicare Provider Utilization and Payment Data

Part B Carrier Summary Data File

Part B National Summary Data File

Provider of Services (POS)

Shared Savings Program Accountable Care Organizations (ACO) PUF

For more information on the pricing specific to other PUF files, please consult the CMS Public Use File webpage

 

Additional Information

If you are unsure of the files that you need for you study, you can take a look at the available files on the ResDAC website and/or contact ResDAC via email at resdac@umn.edu or phone (888-973-7322) to discuss your study.

 

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