Medicare

Medicare is a health insurance program, administered by the United States government, for people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other special criteria like the End Stage Renal Disease program (ESRD).

Medicare Provider Analysis and Review (MedPAR)

The MedPAR file contains information about inpatient (IP) hospital and skilled nursing facility (SNF) stays that were covered by Medicare.  MedPAR records are created by rolling up information for a single stay from individual IP and SNF claims. The data on these claims was originally submitted on the CMS 1450 or UB04.

This file includes (variable highlights)

  • Diagnosis (ICD diagnosis),
  • Procedure (ICD procedure code)
  • Admission, discharge dates or end date of covered benefits
  • Charge amounts, total and assigned to specific departments
  • FFS reimbursement amount
  • Hospital provider identification number 
  • Some dummy records for Medicare managed care coverage of IP stays