Acute Inpatient PPS

FY 2013 Final Rule Data Files
Type of File
Impact File and Data Files

Below are the data files and impact file for the FY 2013 final Rule. The tables for the FY 2013 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 13 FR Impact File: This file contains data elements by provider that were used in calculating the final FY 2013 rates and impacts.

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.

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 2011, using the V28 Grouper).

4. Standardizing File: This file is used to standardize charges for the rate building process.

5. County to CBSA Crosswalk File: This file lists the CBSA, SSA county code and FIPS county code for all counties. Any changes to the CBSAs through March 2010 have been incorporated.

6. Wage Index Public Use Files: Open Attached Zip file. Attached is a PDF with a description of each zip file. Main zip file contains 6 zip files:

1. FY 2013 Final Rule Wage Index PUFs

2. FY 2013 Final Rule Average Hourly Wage by Provider and CBSA Public Use File

3. FY 2013 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages by Provider

4. FY 2013 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA

5. FY 2013 Final Occupational Mix Factor by Provider PUF

6. FY 2013 Final Rule AHW by Provider Area Listing

7.  Hospital Readmissions Reduction Program Supplemental Data File: This file contains the FY 2013 payment adjustment factors under the Hospital Readmissions Reduction Program, and the number of cases and excess readmissions ratios for the three conditions (heart failure, pneumonia and acute myocardial infarction) used to calculate the payment adjustment factors.

8. 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 2013. 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.