FY 2019 Final Rule and Correction Notice Data Files
Type of File
Impact File and Supporting Data Files
FY 19 Impact File (Final Rule and Correction Notice) [ZIP, 3MB]
: This file contains data elements by provider that were used in calculating the FY 2019 rates and impacts for the FY 2019 final rule and correction notice. Note: The impact file is used to model payments and estimate impacts for the FY 2019 final rule and uses the best available data at the time of the final rule. It should NOT be relied upon for actual payment in FY 2019.
AOR/BOR File [ZIP, 1MB]
: This zip file for the FY 2019 final rule contains one excel spreadsheet with multiple tabs: one for the After Outliers Removed (AOR) and one for the Before Outliers Removed (BOR). There are also two tabs 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.
Case Mix Index File [ZIP, 186KB]
: 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 2017, using the V34Grouper).
FY 2019 Final Rule: HCRIS Data File [ZIP, 24MB] - Opens in a new window
: 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 database for the Medicare cost reports is the Healthcare Cost Report Information System (HCRIS). The CCRs used in the calculation of the MS‑DRG relative weights for the FY 2019 IPPS Final Rule are derived from the March 31, 2018 quarterly update of the FY 2016 HCRIS. (HCRIS is updated on a quarterly basis).
FY 2019 Wage Index PUFs; S3 Part II and Occ Mix Data
FY 2019 Average Hourly Wage by Provider and CBSA Public Use File
FY 2019 Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Occupational Mix Factor by Provider
FY 2019 Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
FY 2019 AHW by Provider Area Listing
FY 2019 IPPS Final Rule: Hospital Readmissions Reduction Program Supplemental Data File [ZIP, 1MB]
: This file contains the final FY 2019 readmissions payment adjustment factors under the Hospital Readmissions Reduction Program that will be applicable to discharges occurring on or after October 1, 2018. It also contains information on the number of cases for each of the applicable conditions and the base operating DRG payments used in the calculation of the readmission payment adjustment factors.
Tab 2: The correction notice FY 2019 Factor 3 and data used to calculate Factor 3 to implement Section 3133 of the ACA, Improvements to Medicare DSH Payments.
Tab 3: The list of hospitals used in the correction notice that have undergone a merger so that the data of the merged hospitals have been combined to calculate the surviving hospital’s Factor 3 for FY 2019.
Tab 4: The final rule FY 2019 Factor 3 and data used to calculate Factor 3 to implement Section 3133 of the ACA, Improvements to Medicare DSH Payments.
Tab 5: The list of hospitals used for the final rule that have undergone a merger so that the data of the merging hospitals have been combined to calculate the Factor 3 for the surviving hospital for FY 2019.
Tab 6: The data used for Medicare DSH estimates to support the calculation of the Factor 1. The Factor 3 in the second tab is the amount available for uncompensated care payments that a DSH hospital will receive under the implementation of Section 3133 of the Affordable Care Act. DSH hospitals are identified as those hospitals that are projected to receive DSH payments for FY 2019.