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Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS), previously known as the Health Care Financing Administration (HCFA), is a federal agency within the United States Department of Health and Human Services (DHHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the State Children's Health Insurance Program (SCHIP), and health insurance portability standards.

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Medicare Provider Utilization and Payment Data - Inpatient

The Inpatient Utilization and Payment Public Use File (Inpatient PUF) provides information on inpatient discharges for Medicare fee-for-service beneficiaries. The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments. The PUF is organized by hospital and Medicare Severity Diagnosis Related Group (MS-DRG) and covers Fiscal Year (FY) 2011 through FY 2016.

Hospitals determine what they will charge for items and services provided to patients and these charges are the amount the hospital bills for an item or service. The Total Payment amount includes the MS-DRG amount, bill total per diem, beneficiary primary payer claim payment amount, beneficiary Part A coinsurance amount, beneficiary deductible amount, beneficiary blood deducible amount and DRG outlier amount.

Inpatient PUF users will be able to make comparisons between individual hospital-level charges and payments within local markets, and nationwide, for services that might be furnished in connection with a particular inpatient stay.

Source: dnav.cms.gov

Data and Resources

FieldValue
Publisher
Modified
2018-09-05
Release Date
2018-09-05
Frequency
Annually
Homepage URL
Identifier
630
License
Contact Name
Health Data Initiative
Contact Email
Public Access Level
Public
POD Theme
Medicare
Bureau Code
009:38 - Centers for Medicare and Medicaid Services
Program Code
009:000 - Department of Health and Human Services - (Primary Program Not Available)
Data Quality
True
Harvested from dnav.cms.gov
Harvest Source Titlednav.cms.gov
Harvest Source URIhttps://dnav.cms.gov/api/healthdata
Last Harvest PerformedTue, 08/04/2020 - 02:51