AOR/BOR File (Final Rule and Correction Notice) [ZIP, 2MB]
: This zip file for the FY 2020 final rule and correction notice contains one excel spreadsheet with multiple tabs: final rule and correction notice tabs for the After Outliers Removed (AOR) v37 and final rule and correction notice tabs for the Before Outliers Removed (BOR) v37. There are also two tabs for v36 AOR and BOR. Additionally, there are 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, 187KB]
: 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 2018, using the V35 Grouper).
FY 2020 Final Rule: HCRIS Data File - 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 2020 IPPS Final Rule are derived from the March 31, 2019 quarterly update of the FY 2017 HCRIS. (HCRIS is updated on a quarterly basis).
FY 2020 Final Rule Wage Index PUFs; S3 Part II and Occ Mix Data
FY 2020 Final Rule Average Hourly Wage by Provider and CBSA Public Use File
FY 2020 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Occupational Mix Factor by Provider
FY 2020 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
FY 2020 Final Rule AHW by Provider Area Listing
Hospital Readmissions Reduction Program Supplemental Data File [ZIP, 1MB]
: This file contains the final FY 2020 payment adjustment factors CMS applies to discharges that occur on or after October 1, 2019. It also contains information on the number of discharges used to determine the ratio of conditions/procedures-specific payments to total base operating diagnosis-related (DRG) payments.
Tab 2: The correction notice FY 2020 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 2020.
Tab 4: The final rule FY 2020 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 2020.
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.