Search Data Variables

Monthly Medicare Advantage (MA) enrollment indicator (September).

CODE INDICATING THE TAXONOMY CODE FOR HOME AND COMMUNITY-BASED SERVICES. TAXONOMY CODE IS ONLY ADDED FOR WAIVER SERVICES IDENTIFIED IN 'MSIS TYPE OF PROGRAM CODE' = 6 OR 7.

This variable is the total Medicare payments in the home health (HH) setting for a given year. The total Medicare payments for HH are calculated as the sum of CLM_PMT_AMT for all HH claims where the CLM_PMT_AMT >= 0.

This variable indicates the total amount paid for Home Health (HH) visits by a primary payer other than Medicare. It is the sum of all the primary payer amounts (NCH_PRMRY_PYR_CLM_PD_AMT from each claim) in the HH setting for the year.

This variable is the count of home health (HH) visits for the year. The CCW variable CLM_HHA_TOT_VISIT_CNT is used to obtain this variable.

Codes indicating that the service represents a long-term care home and community based service (HCBS) or support for an individual with chronic medical and/or mental conditions. The codes are to help clearly delineate between acute care and long-term care provided in the home and community setting (e.g. 1915(c), 1915(i), 1915(j), and 1915(k) services).

A code that classifies home and community based services (HCBS) listed on the claim into the HCBS taxonomy.

This variable is the count of Medicare covered days in the hospice setting for a given year. This variable equals the sum of the CLM_UTLZTN_DAY_CNT variables on the source claims.

This variable is the total Medicare payments in the hospice (HOS) setting for the year. The total Medicare payments for hospice are calculated as the sum of the CLM_PMT_AMT for all hospice claims where the CLM_PMT_AMT >= 0.

This variable indicates the total amount paid for Hospice stays by a primary payer other than Medicare. It is the sum of all the primary payer amounts (NCH_PRMRY_PYR_CLM_PD_AMT from each claim) in the hospice setting for the year.

This variable is the count of stays (unique admissions, which may span more than one facility) in the hospice setting for a given year. A hospice stay is defined as a set of one or more consecutive hospice claims where the beneficiary is only discharged on the most recent claim in the set.

This field is an indicator that there is reduction in payment amount from the IPPS payment for hospitals that rank in the lowest-performing quartile of selected Hospital Acquired Conditions (HAC).

This field identifies the reduction in payment amount from the IPPS payment for hospitals that rank in the lowest-performing quartile of selected Hospital Acquired Conditions (HAC).

This variable represents the beginning date of the beneficiary’s acute hospital at home care stay.

This variable represents the ending date of the beneficiary’s acute hospital at home care stay.

This variable represents the charge amount for room and board hospital at home care, related to a beneficiary’s acute hospital at home stay.

This variable is the sum of Medicare coinsurance and deductible payments in the hospital outpatient (HOP) setting for a given year. The total beneficiary payment is calculated as the sum of the beneficiary deductible amount and coinsurance amount (variables called REV_CNTR_CASH_DDCTBLE_AMT and REV_CNTR_COINSRNC_WGE_ADJSTD_C) for all HOP claims where the CLM_PMT_AMT >= 0.

This variable is the count of unique emergency department revenue center dates (as a proxy for an ED visit) in the hospital outpatient data file for the year. Revenue center codes indicating Emergency Room use were (0450, 0451, 0452, 0456, or 0459).

This variable is the total Medicare payments in the hospital outpatient (HOP) setting for a given year. The total Medicare payments for HOP are calculated as the sum of CLM_PMT_AMT for all HOP claims where the CLM_PMT_AMT >= 0.

This variable indicates the total amount paid for hospital outpatient (HOP) visits by a primary payer other than Medicare. It is the sum of all the primary payer amounts (NCH_PRMRY_PYR_CLM_PD_AMT from each claim) in the HOP setting for the year.

This variable is the count of unique revenue center dates (as a proxy for visits) in the hospital outpatient (HOP) setting for the year.

Indicates whether the provider’s taxonomy value maps to the hospital provider category; ever in the calendar year.

The amount field (rounded to whole dollars) that represents the Hospital Readmission Reduction (HRR) Program amount. This is a reduction to the claim for readmissions. This field holds a negative amount.

The percent used to identify the readmission adjustment factor that will be applied in determining the payment amount for the Hospital Readmission Reduction (HRR) Program.

The code used to identify whether the facility is participating in the Hospital Readmission Reduction (HRR) Program.

This code denotes the type of hospital on the claim (servicing provider)

Indicates whether the provider’s taxonomy value maps to the hospital unit provider category; ever in the calendar year.

This field represents the amount (rounded to whole dollars) of the Hospital Value Based Purchasing (VBP) Amount. This could be an additional payment on the claim or a reduction, depending on the hospital's score.

Household size used in the Medicaid or CHIP eligibility determination process; most recent in the calendar and all prior years.

“How big of a problem or burden are incontinent events (or ‘accidental leaking of urine’) to you?”

“How big of a problem or burden are incontinent events (or ‘accidental leaking of stool’) to you?”

“It is important for us to understand how you’d like your family, friends, or significant others involved in your care. How important is it to you to have your family or a close friend or significant other involved in discussions about your care?”

“I’d like to talk to you about how you prefer to be involved in your care. Everyone copes with their condition differently. Do you prefer to know as much as you can about the details of your condition and treatment, prefer some information, or prefer not to know or to know very little?”

In the timeframe specific to your market group, how much relief have you felt from pain due to pain treatments and/or medications?

How much of the time have you experienced pain or hurting in the timeframe specific to your market group?

In the timeframe specific to your market group, how much of the time have you limited your day-to-day activities (excluding rehabilitation therapy sessions) because of pain?

In the timeframe specific to your market group, how often have you limited your participation in rehabilitation therapy sessions due to pain?

How much of the time has pain made it hard for you to sleep in the timeframe specific to your market group?

This variable indicates whether the plan charges the Medicare-defined Part D deductible amount.

Indicates whether plan applies the Medicare-defined Part D Initial Coverage Limit (ICL) Amount.

This variable indicates whether Part D plan applies the Medicare-defined Part D Initial Coverage Limit (ICL) Amount.

This variable indicates how the Part D plan charges cost-sharing before the Initial Coverage Limit (ICL) is reached.

IThis variable indicates how the plan applies beneficiary cost-sharing once the beneficiary has reached the Medicare-defined Part D annual Out-of-Pocket (OOP) Cost Threshold (i.e., in catastrophic coverage phase).

This variable Indicates how the Part D plan applies beneficiary cost-sharing once the beneficiary has reached the Medicare-defined Part D annual Out-of-Pocket (OOP) Cost Threshold (i.e., in catastrophic coverage phase).

This variable indicates whether a beneficiary met the condition criteria for human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV/AIDS) as of the end of the calendar year.

This variable shows the date when the beneficiary first met the criteria for the human immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV/AIDS) indicator. The variable will be blank for beneficiaries that have never had the condition. 

This variable indicates whether a beneficiary met the Chronic Condition Data Warehouse (CCW) criteria for hyperlipidemia as of the end of the calendar year.

This variable indicates whether a beneficiary met the Chronic Conditions Warehouse (CCW) criteria for hyperlipidemia (HLP) as of the end of the calendar year.