Title

FY 2015 Final Rule Data Files

Type of File

Impact File and Data Files

Below are the data files and impact file for the FY 2015 final Rule. The tables for the FY 2015 final rule are located on a separate list.

All Excel files contain a text file for 508 compliance. Text files are 508 compliant by themselves.

1. FY 15 Impact File (Final Rule and Correction Notice): The impact file contains data elements by provider that were used in calculating the final FY 2015 rates and impacts. This file contains the final rule impact file issued August 2014 and an updated impact file that corresponds to the correction notice (CMS-1607-CN) issued October 2014.
2. AOR/BOR File: This zip file contains two excel spreadsheets, one for the After Outliers Removed (AOR) and one for the Before Outliers Removed (BOR). There are also two files containing the variable descriptions. The variables in these files are used in the calculations of the relative weights as well as other calculations for the inpatient PPS. All text files in the zip file are for 508 compliance.
3. Case Mix Index File: This file contains the non-transfer adjusted case mix index (CMI) based on the MS-DRGs billed on the claim in the year the claim was incurred (that is, during FY 2013, using the V30 Grouper).
4. HCRIS Data File: This zip file contains the SAS file of the March 31, 2014 quarterly update of the FY 2012 HCRIS (Healthcare Cost Report Information System (HCRIS), the database for the Medicare cost reports).  CMS uses hospital cost report data from the Medicare Cost Report, Hospital Form 2552-10, to calculate the Cost-to-Charge Ratios (CCRs) used in the cost based MS-DRG relative weight methodology.  The CCRs used in the calculation of the MS-DRG relative weights for the FY 2015 final IPPS are derived from the March 31, 2014 quarterly update of the FY 2012 HCRIS.  This zip file also includes 3 pdf files that are the HCRIS layout and other references needed to use the SAS file.
5. Standardizing File: This file is used to standardize charges for the rate building process.
6. County to CBSA Crosswalk File: This file contains a crosswalk of county codes to “Old CBSAs” and “New CBSAs”.
7. FY 2015 Final Rule Wage Index Public Use Files: Open Attached Zip file. Attached is a PDF with a description of each zip file. Main zip file contains 5 zip files:
   • FY 2015 Final Rule Wage Index PUFs; S3 Part II and Occ Mix Data
   • FY 2015 Final Rule Average Hourly Wage by Provider and CBSA Public Use File
   • FY 2015 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Occupational Mix Factor by Provider
   • FY 2015 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
   • FY 2015 Final Rule AHW by Provider Area Listing
   • FY 2015 Final Rule Puerto Rico Specific Occupational Mix Adjusted and Unadjusted AHWs by Provider PUF
8. FY 2015 IPPS Hospital Readmissions Reduction Program Supplemental Data File (Final Rule and Correction Notice): This file contains both the proxy and final FY 2015 payment adjustment factors under the Hospital Readmissions Reduction Program and the number of cases and excess readmissions ratios for the five conditions (heart failure, pneumonia and acute myocardial infarction, chronic obstructive pulmonary disease and total hip/total knee arthroplasty) used to calculate the payment adjustment factors. In addition, it contains information on the number of cases for each of the applicable conditions excluded in the calculation of the readmission payment adjustment factors, and it contains DRG relative weight information to estimate the payment adjustment factors. Note, the final FY 2015 payment adjustment factors and supplemental information include the corrections from the October 2014 correction notice (CMS-1607-CN).
9. FY 2015 IPPS Medicare DSH Supplemental Data File (Final Rule and Correction Notice): This file contains the FY 2015 Factor 3 and data used to calculate Factor 3 to implement Section 3133 of the ACA, Improvements to Medicare DSH Payments. In addition, the file contains the data used for Medicare DSH estimates to support of the calculation of Factor 1. Lastly, the file contains a list of hospitals that have underwent a merger so the data of the merging hospitals has been combined to calculate the Factor 3 for the surviving hospital, as finalized in the FY 2015 IPPS Final Rule. The Factor 3 is the proportion of the uncompensated care amount that a DSH hospital will receive under the implementation of Section 3133 of the Affordable Care Act. For FY 2015, the Factor 3 is the hospital's Medicaid days and Medicare SSI days relative to all DSH hospitals Medicaid days and Medicare SSI days. DSH hospitals are identified as those hospitals that are projected to receive DSH for FY 2015. This file contains both the data issued with the final rule in August 2014 and the updated data reflecting the corrections from the October 2014 correction notice (CMS-1607-CN).
10. Definition of Medicare Code Edits: This file contains a description of each coding edit with corresponding ICD-9-CM code lists. There are two chapters in this file. The first chapter contains all the edits and the code lists for FY 2015. The second chapter summarizes, by edit, the changes in the edit code list from the last release of the MCE. This document is 508 compliant.