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…
Under changes to the Part 2 regulations on January 17, 2017, CMS is now permitted to include substance use disorder claims data in the Research Identifiable Files (RIFs). Research Identifiable Files shipped or extracted in the VRDC after 05/22/2017 are no longer subject to the redaction.
Provide the steps to identify the drug name from the RxNorm database for the NDCs in the BSA PDE PUF.
CMS updated several Medicare cost report forms. As a result, during the year of the transition and up to one year after, the facility will have two separate data downloads, one that includes all the data collected under the old form and another one under the new form.
States that have "Opted-In" to data sharing under the State Research request process are required to submit quarterly logs to CMS.
To provide estimated file sizes for recent, commonly requested 5% and 100% Research Identifiable Files.
Researchers working with the Research Identifiable (RIF) MedPAR or Inpatient and Skilled Nursing Facility (SNF) claims may find records that do not appear to correspond to the year of the file. This article explains these instances.
Researchers who are interested in studying Part D utilization within the Medicare Current Beneficiary Survey (MCBS) can do so by using the MCBS Cost and Use for years 2006 through 2013. This article provides an overview of where Part D utilization information located within the MCBS during these years, as well as the list of PDE variables included with the file.
Values that are "missing" in the Minimum Data Set (MDS) nursing home assessment can be represented by several different symbols. While all of these symbols represent that a value is "missing," the specific symbol indicates the specific reason why the value is missing.
CMS research files do not include beneficiary risk adjustment scores. However, CMS does provide the programming code and instructions to calculate the three risk adjustments that CMS uses as the basis for managed care payment.
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.
This article describes the difference between two similiar variables in the carrier file -the Line NCH Payment Amount and Line Provider Payment Amount.
This article explains possible discrepancies when using the outpatient file to calculate payment amounts at the claim level and revenue center level.