Updated research request forms and data security approval required beginning 4/24/23
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…
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.
Requirements for Institutional Review Board (IRB) Review and HIPAA Waiver Documentation for RIF DUA Request Submissions
CMS must ensure that all research requests for identifiable (RIF) data have IRB documentation to satisfy the requirements of the Common Rule and the Health Insurance Portability and Accountability Act (HIPAA). This article describes the requirements…
The purpose of this article is to provide an overview of the Centers for Medicare & Medicaid Services' (CMS') Price (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.
Availability of provider variables Provider variable completeness Provider variable definitions
This article presents the data options available to researchers studying the End-Stage Renal Disease (ESRD) population.
Medicare-paid observation stays may be found in the Medicare Outpatient, Inpatient, or MedPAR files. This article describes how to identify observation stays that appear in each as defined by CMS billing guidance.
A number of CMS Limited Data Set (LDS) files are released first as a Proposed Rule file and then as a Final Rule file. This article provides a brief description of the differences between those two files.
The purpose of this article is to describe what ambulatory surgical centers are and to explain how this provider type differs from other provider types that bill Medicare.
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.
The purpose of this knowledge base article is to 1) present an overview of International Classification of Disease (ICD) codes and versions available, 2) describe where researchers can find these codes in the Medicare claims, and 3) understand how ICD codes appear in the data.
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 used in Medicare claims files.
This article provides instructions on how to open the Medicare Physician/Supplier Procedure Summary Master (PSPS) file in Microsoft Access or SAS.
The purpose of this article is to define a Long-Term Care Hospital (LTCH) and to identify the files that contain claims submitted by a LTCH.
CMS offers several claim-level files that contain outpatient claims; that is, facility claims submitted for care covered under Part B. Three versions of the LDS files are described:Outpatient file,Outpatient Prospective Payment System (OPPS) file, and OPPS Partial Hospitalization file.