Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program (PHP)

This file contains select claim level data and is derived from 2025 claims for partial hospitalization program (PHP) services, intensive outpatient (IOP) services, and OPPS hospital claims with dates of service from January 1, 2025 - December 31, 2025 that were received, processed, and paid through December 31, 2025. Please refer to the CY 2027 OPPS/ASC proposed rule and the CY 2027 OPPS claims accounting for a full discussion of the trims and exclusion applied to the PHP and IOP claims and other OPPS claims included in this file and the methodology used for modeling costs for days with 3 and 4 or more services. This file includes data elements such as diagnosis codes, bill type, outlier payments, and service revenue payments.  This file includes 50,778 claims for PHP and IOP claims furnished by hospitals and community mental health centers (CMHCs) paid under the OPPS. This is a flat file.  The LDS record length is 9,997, blocksize is 32,760.

The OPPS PHP/IOP file will be available twice a year, once for the OPPS Proposed Rule in late spring/early summer, and again for the Final Rule within a month of publication of the OPPS Final Rule in the Federal Register.

Cost: $1,000    

For file cost and availability, please see the LDS Worksheet. (ZIP)