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Knowledgebase
Introductory
Articles
CMS offers files from aggregate data to individual person level data. This article describes the differences between the aggregate, public use files, the limited data sets,…
This article describes the Federal Regulations that govern the release of CMS data for research.
The purpose of this article is to identify 1) common strengths of Medicare and Medicaid administrative data and 2) broad limitations for researchers to consider when…
Popular
Articles
This article provides guidance on how to identify hospital emergency room claims from the Medicare files.
Providers that bill Medicare use codes for patient diagnoses and codes for care, equipment, and medications provided. This articles provides resources to identify the codes…
To describe the CMS cell size suppression policy and provide examples of common scenarios and possible options.
Featured Article
There are many different provider variables in the Medicare Fee-for-Service (FFS) Claims and Encounter data. Researchers are often interested in the performing NPI and/or the facility CCN or organizational NPI, but other variables are sometimes…
To describe the CMS cell size suppression policy and provide examples of common scenarios and possible options.
There are many different provider variables in the Medicare Fee-for-Service (FFS) Claims and Encounter data. Researchers are often interested in the performing NPI and/or the facility CCN or organizational NPI, but other variables are sometimes useful. The purpose of this article is to help you understand these variables and we present the completeness of these data to assist researchers who are designing research studies using Medicare FFS claims and Encounter data.
The purpose of this article is to provide an overview of the Centers for Medicare & Medicaid Services' (CMS') payment standardization process, as well as provide methodological documentation that explains how the standardized claim payment amounts for Medicare Part A, Part B, and Part D claims are calculated.
States that have "Opted-In" to data sharing under the State Research request process are required to submit quarterly logs to CMS.
Medicare managed care enrollment has fluctuated over the years and is a frequently requested statistic. Often researchers are interested in penetration rates or the percentage of Medicare beneficiaries enrolled in a Medicare managed care plan. These plans are also referred to as Medicare Part C, Medicare Advantage (MA), or Medicare Health Maintenance Organizations (HMOs).
This article provides a link and overview of the document on finder and crosswalk files written by the CMS data distributor, HealthAPT.
The Centers for Medicare & Medicaid Services (CMS) seeks to ensure the protection of CMS data disclosed to external organizations for research purposes. To accomplish this, CMS has developed the Data Privacy Safeguard Program (DPSP). The DPSP reflects the CMS priorities to both improve data stewardship and to protect the privacy and security of CMS research identifiable files (RIF) that are made available for conducting important research studies.
Beneficiary death information is available in several of the Medicare enrollment files. Limited death information is also found in other files, such as the MedPAR. This article describes the variables found in each.
To describe the CMS policy that prohibits non-US based researchers from accessing identifiable CMS data (RIF and LDS) and provide examples of common scenarios.
The purpose of this article is to describe how to use the Medicare managed care enrollment information found in the Medicare Beneficiary Summary File (MBSF) Research Identifiable File (RIF) or Denominator in the Limited Data Set (LDS). Medicare managed care is sometimes also called Medicare Advantage, Medicare Part C or Medicare + Choice.
The purpose of this article is to identify 1) common strengths of Medicare and Medicaid administrative data and 2) broad limitations for researchers to consider when requesting and using the data.
This article presents the data options available to researchers studying the End-Stage Renal Disease (ESRD) population.