Inpatient Provider Specific File (IPSF) Metadata Dictionary
Complete data dictionary mapping for all available provider attributes.
bedSize number
bed_size
Enter the number of adult hospital beds and pediatric beds available for lodging inpatient. Must be greater than zero.
bundleModel1Discount number
bundle_model_discount
The discount % for hospitals participating in Bundled Payments for Care Improvement Initiative (BPCI), Model 1 (demo code 61).
capitalCostToChargeRatio number
capital_cost_to_charge_ratio
Derived from the latest cost report and corresponding charge data from the billing file. For hospitals for which the MAC is unable to compute a reasonable cost-to-charge ratio, it uses the appropriate statewide average cost-to-charge ratio calculated annually by CMS and published in the "Federal Register."
capitalExceptionPaymentRate number
capital_exception_payment_rate
The per discharge exception payment to which a hospital is entitled.
capitalIndirectMedicalEducationRatio number
capital_indirect_medical_education_ratio
This is for IPPS hospitals and IRFs only. Enter the ratio of residents/interns to the hospital's average daily census. Calculate by dividing the hospital's full-time equivalent total of residents during the fiscal year by the hospital's total inpatient days. Zero-fill for a non-teaching hospital.
capitalPpsPaymentCode string
capital_pps_payment_code
Enter the code to indicate the type of capital payment methodology for hospitals: A = Hold Harmless – cost payment for old capital; B = Hold Harmless – 100% Federal rate; C = Fully prospective blended rate.
caseMixIndex number
case_mix_index
The case mix index is used to compute positions field 18. Zero-fill for all others.
cbsaActualGeographicLocation string
cbsa_actual_geographic_location
Enter the appropriate code for the CBSA 00001-89999, or the rural area, (blank (blank) (blank) 2 digit numeric State code such as _ _ _ 36 for Ohio, where the facility is physically located.
cbsaStandardizedAmountLocation string
cbsa_standardized_amount_location
The appropriate code for the CBSA, 00001-89999 or the rural area, (blank) (blank)(blank) (2 digit numeric State code) such as _ _ _ 3 6 for Ohio, to which a hospital has been reclassified. Leave blank or enter the actual location CBSA (31) if not reclassified. Pricer will automatically default to the actual location CBSA if this field is left blank.
cbsaWageIndexLocation string
cbsa_wi_location
Enter the appropriate code for the CBSA, 00001-89999, or the rural area, (blank)(blank) (blank) (2 digit numeric State code) such as _ _ _ 3 6 for Ohio, to which a hospital has been reclassified due to its prevailing wage rates. Leave blank or enter the actual location CBSA (field 35), if not reclassified. Pricer will automatically default to the actual location CBSA if this field is left blank.
censusDivision string
census_division
The Census division to which the facility belongs for payment purposes. When a facility is reclassified for the standardized amount, MACs must change the census division to reflect the new standardized amount location.
changeCodeForLugarReclassification string
change_code_for_lugar_reclassification
Will contain an "L" if the MSA has been reclassified for wage index purposes under §1886(d)(8)(B) of the Act. These are also known as Lugar reclassifications, and apply to ASC-approved services provided on an outpatient basis when a hospital qualifies for payment under an alternate wage index MSA. Leave blank for hospitals if there has not been a Lugar reclassification.
changeCodeWageIndexReclassification string
change_code_wage_index_reclassification
Enter "Y" if hospital's wage index location has been reclassified for the year. Enter "N" if it has not been reclassified for the year. Adjust annually.
costOfLivingAdjustment number
cost_of_living_adjustment
The COLA adjustment. All hospitals except Alaska and Hawaii use 1.000.
countyCode string
county_code
Enter the County Code. Must be 5 numbers.
effectiveDate string
effective_date
Must be numeric, CCYYMMDD. This is the effective date of the provider's first PPS period, or for subsequent PPS periods, the effective date of a change to the PROV file. If a termination date is present for this record, the effective date must be equal to or less than the termination date. Year: Greater than 82, but not greater than current year. Month: 01-12 Day: 01-31.
ehrReductionIndicator string
ehr_reduction_indicator
Enter a ‘Y’ if the hospital is subject to a reduction due to NOT being an EHR meaningful user. Leave blank if the hospital is an Electronic Health Records meaningful user.
exportDate string
export_date
Must be numeric, CCYYMMDD. Date file created/run date of the PROV report for submittal to CMS CO.
federalPpsBlend string
federal_pps_blend
HH PPS: For “From” dates before 1/1/2021: the value to indicate if normal percentage payments should be made on RAP and/or whether payment should be reduced under the Quality Reporting Program. Valid values: 0 = Make normal percentage payment; 1 = Pay 0%; 2 = Make final payment reduced by 2%; 3 = Make final payment reduced by 2%. pay RAPs at 0%
fiscalYearBeginDate string
fiscal_year_begin_date
Must be updated annually to show the current year for providers receiving a blended payment based on their FY begin date. Must be equal to or less than the effective date.
fiscalYearEndDate string
fiscal_year_end_date
This field is no longer used. If present, must be CCYYMMDD.
hacReductionParticipantIndicator string
hac_reduction_participant_indicator
Enter a ‘Y’ if the hospital is subject to a reduction under the HAC Reduction Program. Enter a ‘N’ if the hospital is NOT subject to a reduction under the HAC Reduction Program.
hospitalQualityIndicator string
hosp_quality_indicator
Code to indicate that hospital meets criteria to receive higher payment per MMA quality standards. Blank = hospital does not meet criteria' 1 = hospital quality standards have been met
hospitalSpecificCapitalRate number
hospital_specific_capital_rate
Must be present unless: • A "Y" is entered in the Capital Indirect Medical Education Ratio field; or A“08” is entered in the Provider Type field; or A termination date is present in Termination Date field. Enter the hospital's allowable adjusted base year inpatient capital costs per discharge. This field is not used as of 10/1/02.
hhrAdjustment number
hrr_adjustment
Enter HRR Adjustment Factor if “1” is entered in prior element (hhrParticipantIndicator). Leave blank if “0” or “2” is entered in AW Participant indicator.
hhrParticipantIndicator number
hrr_participant_indicator
Enter “0” if not participating in Hospital Re-admissions Reduction program. Enter “1” if participating in Hospital Re-admissions Reduction program and payment adjustment is not 1.0000. Enter “2” if participating in Hospital Re-admissions Reduction program and payment adjustment is equal to 1.0000.
intermediaryNumber string
intermediary_number
Assigned intermediary number of the Medicare Administrative Contractor (MAC).
internsToBedsRatio number
interns_to_beds_ratio
This is the provider's intern/resident to bed ratio. Calculated by dividing the provider's full time equivalent residents by the number of available beds. Enter zero for non-teaching hospitals.
lastUpdated string
last_updated
A date formatted as an ISO 8601 date string (YYYY-MM-DD), specifying the date that the provider record was last updated in the VSAM PSF file. This date is inclusive.
lowVolumeAdjustmentFactor number
low_volume_adjustment_factor
Enter the low-volume hospital payment adjustment factor calculated and published by the Centers for Medicare & Medicaid Services (CMS) for each eligible hospital.
ltchDppIndicator string
ltch_dpp_indicator
Enter a ‘Y’ if the LTCH is subject to the DPP payment adjustment. Leave blank if the LTCH is not subject to the DPP payment adjustment.
medicaidRatio number
medicaid_ratio
The Medicaid ratio used to determine if the hospital qualifies for a disproportionate share adjustment and to determine the size of the capital and operating DSH adjustments.
medicarePerformanceAdjustment number
medicare_performance_adjustment
Enter the MPA percentage calculated and published by the Centers for Medicare & Medicaid Services (CMS).
msaActualGeographicLocation string
msa_actual_geographic_location
Enter the appropriate code for the MSA 0040-9965, or the rural area, (blank) (blank) 2 digit numeric State code such as _ _36 for Ohio, where the facility is physically located.
msaStandardizedAmountLocation string
msa_standardized_amount_location
Enter the appropriate code for the MSA, 0040-9965, or the rural area, (blank) (blank) (2 digit numeric State code) such as _ _ 3 6 for Ohio, to which a hospital has been reclassified for standardized amount. Leave blank or enter the actual location MSA (field 13) if not reclassified. Pricer will automatically default to the actual location MSA if this field is left blank.
msaWageIndexLocation string
msa_wage_index_location
Enter the appropriate code for the MSA, 0040-9965, or the rural area, (blank) (blank) (2 digit numeric State code) such as _ _ 3 6 for Ohio, to which a hospital has been reclassified due to its prevailing wage rates. Leave blank or enter the actual location MSA (field 13), if not reclassified. Pricer will automatically default to the actual location MSA if this field is left blank.
nationalProviderIdentifier string
national_provider_identifier
Alpha-numeric 10 character NPI number.
newCapitalHoldHarmlessRate number
new_capital_hold_harmless_rate
Enter the ratio of the hospital's allowable inpatient costs for new capital to the hospital's total allowable inpatient capital costs. Update annually.
newHospital string
new_hospital
Enter "Y" for the first 2 years that a new hospital is in operation. Leave blank if hospital is not within first 2 years of operation.
oldCapitalHoldHarmlessRate number
old_capital_hold_harmless_rate
Enter the hospital's allowable inpatient "old" capital costs per discharge incurred for assets acquired before December 31, 1990, for capital PPS. Update annually.
operatingCostToChargeRatio number
operating_cost_to_charge_ratio
Derived by MACs from the latest settled cost report and corresponding charge data from the billing file. Computed amount by dividing the Medicare operating costs by Medicare covered charges.
operatingDsh number
operating_dsh
Disproportionate share adjustment Percentage. Pricer calculates the Operating DSH effective 10/1/91 and bypasses this field. Zero-fill for all hospitals 10/1/91 and later.
passThroughAmountForAllogenicStemCellAcquisition number
pass_through_amount_for_allogenic_stem_cell_acquisition
The per diem payment amount based on the interim payments to the hospital that includes acquisition amounts for allogeneic stem cell. The pass-through amount is not included in total pass-through and miscellaneous field.
passThroughAmountForCapital number
pass_through_amount_for_capital
Per diem amount based on the interim payments to the hospital. Zero-fill if this does not apply.
passThroughAmountForDirectGraduateMedicalEducation number
pass_through_amount_for_direct_graduate_medical_education
Per diem amount of direct graduate medical education to be excluded from Medicare Advantage (MA) capitation rates per regulation.
passThroughAmountForDirectMedicalEducation number
pass_through_amount_for_direct_medical_education
Per diem amount based on the interim payments to the hospital Zerofill if this does not apply.
passThroughAmountForKidneyAcquisition number
pass_through_amount_for_kidney_acquisition
Per diem amount of kidney acquisition costs to be excluded from MA capitation rates per regulation.
passThroughAmountForOrganAcquisition number
pass_through_amount_for_organ_acquisition
Per diem amount based on the interim payments to the hospital. Zerofill if this does not apply.
passThroughAmountForSupplyChain number
pass_through_amount_for_supply_chain
Per diem amount of Supply Chain Cost to be excluded from Medicare Advantage (MA) capitation rates per regulation.
passThroughTotalAmount number
pass_through_total_amount
Per diem amount based on the interim payments to the hospital. Zerofill if this does not apply.
ppsBlendYearIndicator string
pps_blend_year_indicator
The year where there is a blend of payments from cost-based principles and the Federal Long Term Care Hospital (LTCH) PPS rate.
caseMixAdjustedCostPerDischarge_PpsFacilitySpecificRate number
pps_facility_specific_rate
For PPS hospitals and waiver state non-excluded hospitals, the base year cost per discharge divided by the case mix index. Will have zero for new providers.
providerCcn string
provider_ccn
Alpha-numeric 6-13 character provider number. Also known as Oscar Number.
providerType string
provider_type
This identifies the inpatient provider type, such as short term facility, long-term, psychiatric, rehabilitation facility, and so on.
soleCommunityOrMedicareDependentHospitalBaseYear string
sole_community_or_medicare_dependent_hospital_base_year
Leave blank if not a sole community hospital (SCH) or a Medicare dependent hospital (MDH) effective with cost reporting periods that begin on or after April 1, 1990. If an SCH or an MDH, show the base year for the operating hospital specific rate, the higher of either 82 or 87. See §20.6. Must be completed for any SCH or MDH that operated in 82 or 87, even if the hospital will be paid at the Federal rate. Eff. 10/1/12, MDHs are no longer valid provider types.
specialPaymentIndicator string
special_payment_indicator
The code that indicates the type of special payment provision that applies. Blank = not applicable Y = reclassified 1 = special wage index indicator 2 = both special wage index indicator and reclassified D = Dual reclassified
specialProviderUpdateFactor number
special_provider_update_factor
Zero-fill for all hospitals after FY91. This Field is obsolete for hospitals as of FY92. Effective 1/1/2018, this field is used for HHAs only. Enter the HH VBP adjustment factor provided by CMS for each HHA. If no factor is provided, enter 1.00000.
specialWageIndex number
special_wage_index
Enter the special wage index that certain providers may be assigned. Enter zeroes unless the Special Payment Indicator field equals a “1” or “2.”
stateCode string
state_code
Enter the 2-digit state where the provider is located. Enter only the first (lowest) code for a given state. For example, effective October 1, 2005, Florida has the following State Codes: 10, 68 and 69. MACs shall enter a “10” for Florida’s state code.List of valid state codes is located in Pub. 100-07, Chapter 2, Section 2779A1.
supplementalSecurityIncomeRatio number
supplemental_security_income_ratio
The SSI ratio used to determine if the hospital qualifies for a disproportionate share adjustment and to determine the size of the capital and operating DSH adjustments.
supplementalWageIndex number
supplemental_wage_index
Enter the supplemental wage index that certain providers may be assigned. Enter zeroes if it does not apply.
supplementalWageIndexIndicator string
supplemental_wage_index_indicator
Enter the supplemental wage index indicator that certain providers may be assigned: 1=Prior Year Wage Index*; 2=Future use; 3=Future use; Enter blank if it does not apply Note: For LTCH’s providers this is the IPPS prior year wage index.
temporaryReliefIndicator string
temporary_relief_indicator
Enter a “Y” if this provider qualifies for a payment update under the temporary relief provision, otherwise leave blank.
terminationDate string
termination_date
Termination Date in this context is the date on which the reporting MAC ceased servicing the provider. Must be zeroes or contain a termination date. Must be equal to or greater than the effective date. If the provider is terminated or transferred to another MAC, a termination date is placed in the file to reflect the last date the provider was serviced by the outgoing MAC.
uncompensatedCareAmount number
uncompensated_care_amount
Enter the estimated per discharge uncompensated care payment amount calculated and published by CMS for each hospital.
vbpAdjustment number
vbp_adjustment
Enter VBP Adjustment Factor. If prior element (vpbParticipantIndicator) is blank, leave blank.
vpbParticipantIndicator string
vpb_participant_indicator
Enter “Y” if participating in Hospital Value Based Purchasing. Enter “N” if not participating. Note if Data Element AD (Hospital Quality Ind) is blank, then this field must = N.
waiverIndicator string
waiver_indicator
Y = waived (Provider is not under PPS). N = not waived (Provider is under PPS).