HOSPITAL COST REPORT INFORMATION SYSTEM

(HCRIS)

SPECIFICATIONS FOR THE HOSPITAL DATA SET

DATA SOURCE: HCFA FORM 2552-96

FOR COST REPORTING PERIODS BEGINNING ON OR AFTER OCTOBER 1, 1995

TABLE OF CONTENTS

PAGE(S) FIELD(S)

General Information . . . . . . . . . . . . . . . . . . . . . A

Identifying Information and Other Data . . . . . . . . .. . . . . .	1 - 4	F1 - F77

Statistical and Summary Utilization Data . . . . . . . . . . . . .	4 - 7	F78 - F180

Hospital Wage Index Salary Information . . . . . . . . . . . .. . .	7 - 12	F181- F360

Total Facility Costs . . . . . . . . . . . . . . . . .	13 - 16	F361 - F527

Reimbursable Costs, Before Cost Allocation - Facility . . . . . .	16 - 17	F528 - F611

Medical Education Costs, Included Allocated Overhead - Facility . . . . .	18	F612 - F616

Total Costs, After Cost Allocation - Facility . . . . . . . . .	18 - 19	F617 - F678

RT/PT Limit Adjustment and Total Costs After

RT/PT Adjustment and RCE Disallowance - Facility . .	. . . . . .	19 - 20	F679 - F727

Total Capital and Operating Cost Reduction

Amounts to Outpatient Service Costs - Facility . . . . . . . .	20	F728 - F729

Total Inpatient Charges - Facility . . . . . . . . . . . . .	21	F730 - F773

Total Outpatient Charges - Facility. . . . . . . . . . . . . .	22	F774 - F805

Ancillary Cost to Charge Ratios

Used to Compute Medicare Part A Ancillary Costs	. . . . . . .	. .	23	F806 - F836

Ancillary Cost to Charge Ratios

Used to Compute Medicare Part B Ancillary Costs . . . . . . .	24	F837 - F867

Medicare Part A Inpatient Routine Charges - Hospital . . . . . . .	24	F868 - F873

Medicare Part A Ancillary Charges - Hospital . . . . . . . . .	25	F874 - F906

Medicare Part A Ancillary Costs - Hospital . . . . . . . . . . 26	F907 - F938

Summary of Medicare Part A Inpatient Routine

and Ancillary Operating Costs - Hospital . . . . . . . . . . .	27	F939 - F958

Medicare Part A Ancillary Costs - Subprovider I . . . . . . . . .	28	F959 - F990

Summary of Medicare Part A Inpatient Routine

and Ancillary Operating Costs - Subprovider I . . . . . . . . .	29	F991 - F1004

Medicare Part A Ancillary Costs - Subprovider II . . . . . . . .	30	F1005 - F1036

Summary of Medicare Part A Inpatient Routine

and Ancillary Operating Costs - Subprovider II . . . . . . . . . .	31	F1037 - F1050

Outpatient Ambulatory Surgical Center

Medicare Part B Charges - Hospital . . . . . . . . . . .	32	F1051 - F1084

Outpatient Radiology Medicare Part B Charges - Hospital . . . . . . . .	33	F1085 - F1117

Other Outpatient Diagnostic Medicare Part B Charges - Hospital . . . .	34	F1118 - F1150

All Other Mediare Part B Charges - Hospital . . . . . . . . .	35	F1151 - F1185

All Other Medicare Part B Charges - Subprovider I

and Subprovider II . . . . . . .	36-37	F1186 - F1255

Outpatient Ambulatory Surgical Center Medicare Part B Costs - Hospital . .	38	F1256 - F1289

Outpatient Radiology Medicare Part B Costs - Hospital . . . . . . . . 39	F1290 - F1322

Other Outpatient Diagnostic Medicare Part B Costs - Hospital . . . . .	40	F1323 - F1355

All Other Part B Medicare Costs - Hospital . . . . . . . . . .	41	F1356 - F1389

All Other Part B Medicare Costs - Subprovider I

and Subprovider II . . . . . . . .	42-43	F1390 - F1457

Analysis of Changes in Old Capital Asset Balances - Facility . . . . . . .	44	F1458 - F1497

Analysis of Changes in New Capital Asset Balances - Facility . . . . . . .	45	F1498 - F1537

Reconciliation of Capital Costs - Facility . . . . . . . . . . . . 46	F1538 - F1572

Allocation of Old Capital Related Costs - Facility . . . . . . . . .	47-48	F1573 - F1630

Allocation of New Capital Related Costs - Facility . . . . . . . . .	48-49	F1631 - F1688

Medicare Part A Inpatient Routine

Old Capital Costs - Hospital and Subprovider(s) . . . . . . . .	50	F1689 - F1698

Medicare Part A Inpatient Routine

New Capital Costs - Hospital and Subprovider(s) . . . . . . . .	50	F1699 - F1708

Medicare Part A Ancillary Old and New Capital Costs - Hospital . . . .	51-52	F1709 - F1770

Total Medicare Part A Ancillary Capital Costs - Subprovider I

and Subprovider II . . . . .	52	F1771 - F1774

Medicare Part A Inpatient Routine Service Other Pass

Through Costs - Hospital and Subprovider(s) . . . . .	53	F1775 - F1784

Medicare Part A Ancillary Service Other Pass Through

Costs - Hospital, Subprovider I, and Subprovider II . . . . . . .	53-54	F1785 - F1817

Medicare Part A PPS Reimbursement - Hospital . . . . . . . .	54-55	F1818 - F1847

Medicare Part B Reimbursement Settlement -

Hospital, Subprovider I, and Subprovider II . . . . . . . .	55-57	F1848 - F1910

Outpatient Ambulatory Surgical Center

Medicare Part B Settlement - Hospital . . . . . . . . .	57	F1911 - F1915

Outpatient Radiology Services

Medicare Part B Settlement - Hospital . . . . . . . . .	57	F1916-F1920

Other Outpatient Diagnostic Procedures

Medicare Part B Settlement - Hospital . . . . . . . .	58	F1921 - F1925

Medicare Part A TEFRA Settlement

Hospital, Subprovider I, and Subprovider II . . . . . .	58-60	F1926 - F1974

Medicare Part A Cost Reimbursement

Hospital, Subprovider I, and Subprovider II . . . . . .	61-63	F1975 - F2032

Medicare Direct Graduate Medical Education (GME) Data - Facility . .	63	F2033 - F2037

Financial Data - Facility . . . . . . . . . . . . .	64-65	F2038 - F2098

Patients Revenues and Statement of Revenues/Expenses . . . . .	66-67	F2099 - F2134

Statement of Revenues and Expenses . . . . . . . . . .	67	F2135 - F2146

Calculation of Capital Payment . . . . . . . . . . . . . . . . 68 - 69	F2147 - F2188

Tables . . . . . . . . . . . . . . . . . . . . 70 - 76