Updated research request forms and data security approval required beginning 4/24/23
Data File Search
What does this file include? (variable highlights)
Records included based on discharge date within the file calendar year
Active, non-voided, non-denied final action claims
Diagnosis codes
Present on Admission Indicator
Procedure codes
Procedure date
Discharge status
Charges and payments
Provider identifier
Special considerations
Available encounter data may vary by state, year and eligibility group.
CMS continues to work with states to address data quality issues. In addition to preliminary and fully mature…
Program:
Medicaid
What does this file include? (variable highlights)
As appropriate for the type of service on the record:
Diagnosis codes
Procedure code
Charges and payments
Provider identifiers
Special considerations
Encounter data reporting may vary by state, year and eligibility group.
CMS continues to work with states to address data quality issues. In addition to preliminary and fully mature files, CMS may provide updated releases of the files for a given year. CMS has fee information for TAF data pricing.
ResDAC…
Program:
Medicaid
What does this file include? (variable highlights)
Diagnosis codes
Present on Admission indicator
Admission date
Charges and payments
Provider identifier
Patient discharge status or destination
Counts of covered days
Special considerations
Encounter data reporting may vary by state, year and eligibility group.
Stays may be made up of multiple records.
Long term care services provided to community-dwelling beneficiaries are found in the TAF OT file.
CMS continues to work with states to address data quality…
Program:
Medicaid
What does this file include? (variable highlights)
National Drug Code (NDC)
Days supply covered by the prescription
Charges and Medicaid payments (FFS only)
National Provider Identifier (NPI) for the billing provider
Special considerations
Encounter data reporting may vary by state, year and eligibility group.
Information on the drug name, dosage and format is not recorded in the TAF RX file. An external source of NDC data will be required if that information is needed.
CMS continues to work with…
Program:
Medicaid
What does this file include (variable highlights)
Managed Care Plan type
Waivers such as 1115
Eligible population indicators such as CHIP coverage
Special considerations
This file does not contain individual service records but contains information about plans that can be linked to individual enrollment information and may help put utilization into context.
CMS continues to work with states to address data quality issues. In addition to preliminary and fully mature files, CMS may provide updated releases…
Program:
Medicaid
What does this file include (variable highlights)
Provider taxonomy indicators such as eye or vision, behavioral health, speech language or hearing services
Residential treatment facility indicator
Substance Use Disorder Service provider indicator
Special considerations
This file does not contain individual service records but contains information about providers that can be linked to individual service records.
CMS continues to work with states to address data quality issues. In addition to preliminary…
Program:
Medicaid
What does this file include? (variable highlights)
10 diagnosis code fields
7 procedure code fields
Discharge status
Charges and payments (FFS only)
Provider identifier
Special considerations
Encounter record reporting may not be complete. Data reporting may vary by state, year and eligibility group.
Program:
Medicaid
What does this file include? (variable highlights)
As appropriate for the type of service on the record:
2 diagnosis codes
1 procedure code
Broadly defined Type of Service codes
Charges and payments (FFS only)
Provider identifier
Special considerations
Encounter record reporting may not be complete. Data reporting may vary by state, year and eligibility group
Program:
Medicaid
What does this file include? (variable highlights)
5 diagnosis codes
Admission date
Charges and payments (FFS only)
Provider identifier
Patient discharge status or destination
Counts of covered days
Special considerations
Encounter record reporting may not be complete. Data reporting may vary by state, year and eligibility group.
Stays may be made up of multiple records.
Long term care services provided to community-dwelling beneficiaries are found the MAX OT file.
Program:
Medicaid
The Medicaid RX Prescription Drug file includes fee-for-service (FFS) claim and managed care encounter records that contain a National Drug Code (NDC) for a filled prescription.
What does this file include? (variable highlights)
National Drug Code (NDC)
Days supply covered by the prescription
Charges and Medicaid payments (FFS only)
National Provider Identifier (NPI) for the billing provider
Special considerations
Encounter record reporting may not be complete. Data reporting may vary by state, year,…
Program:
Medicaid