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Long-Term Care Hospital (LTCH) PPS Expanded Modified MEDPAR

The Medicare Provider Analysis and Review (MEDPAR) file contains records for 100% of Medicare beneficiaries who received hospital inpatient services at a LTCH as defined in Sections 1886(d)(1)(B)(iv) and 1861(ccc) of the Social Security Act. The file contains same data elements found in the National Hospital MEDPAR Limited Data Set (LDS), including the billed Diagnosis-Related Group (DRG), the current DRG and the proposed/final DRG. The records are stripped of most data elements that will permit identification of beneficiaries. The six position Medicare billing number identifies the LTCH. The file is available to persons qualifying under the terms of the Routine Use Act as outlined in the December 24, 1984, "Federal Register" and amended by the July 2, 1985, Notice. This file consists of between  approximately 140,000 and 160,000 records.

Data Alert 2016: The LDS MedPAR layout has been revised for the FY2016 Update. See the ‘FY2016_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The fields for ‘Accountable Care Organization (ACO) Identification Number’, ‘Revenue Center Allogeneic Stem Cell Acquisition/Donor Services’, and ‘Islet Add-On Payment Amount’ have been added to the file. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been appended to the LTCH PPS EMM file.

Data Alert 2015: The LDS MedPAR layout has been revised for the FY2015 Update. See the ‘FY2015_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The field for ‘IPPS Flex Payment 6 Amount’ has been replaced by ‘HAC Reduction Payment Amount’. The fields for ‘Site Neutral Payment Based on Cost Amount’, ‘Site Neutral Payment Based on IPPS Amount’, ‘Full Standard Payment Amount’, ‘Short Stay Outlier (SSO) Payment Amount’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 1 Code’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 2 Code’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 3 Code’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 4 Code’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 5 Code’, ‘Residual Payment Indicator Code’, ‘Claim Representative Payee (RP) Indicator Code’, and ‘Revenue Center Representative Payee (RP) Indicator Code’ have been added to the file. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been appended to the LTCH PPS EMM file.

Data Alert 2014: The LDS MedPAR layout has been revised for the FY2014 Update. See the ‘2014_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The field position for ‘Bundled Model Discount Percent’ has been updated and has subsequently changed the positions of all fields starting on and after position 1634. The fields for ‘EHR Payment Adjustment Amount’, ‘PPS Standard Value Payment Amount’, ‘Final Standard Amount’, ‘IPPS Flex Payment 6 Amount’, ‘IPPS Flex Payment 7 Amount’, Patient Add-On Payment Amount’, ‘HAC Program Reduction Indicator Switch’, ‘EHR Program Reduction Indicator Switch’, ‘Prior Authorization Indicator Code’, ‘Unique Tracking Number’, and ‘2 Midnight Stay Indicator Switch’ have been added to the file. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been created and appended to the LTCH PPS EMM file.

Data Alert 2013: The LDS MedPAR layout has been revised for the FY2013 Update. See the ‘2013_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The field positions for ‘VBP Adjustment Percent’ and ‘HRR Adjustment Percent’ have been updated and have subsequently changed the positions of all fields starting on and after position 1636. The fields for ‘Sequestration Reduction Amount’, ‘Uncompensated Care Payment Amount’, ‘Bundled Adjustment Amount’, ‘VBP Adjustment Amount’, and ‘HRR Adjustment Amount’, have been added to the file.

1.  The Notice of Proposed Rule Making (NPRM), which contains the proposed annual LTC-DRG update, is published in the "Federal Register" usually available in April.  This file is derived from the MEDPAR file with a cutoff of three months after the end of the fiscal year (December file).

2.  The Final Rule, which contains the annual LTC-DRG update, is published in the "Federal Register" usually by the first week of August. This file is derived from the MEDPAR file with a cutoff of six months after the end of the fiscal year (March file).

Media: DVD
Cost: $100

Data Format:  Comma separated variable block (CSV) with SAS® read-in program
Available: FY 2004 - FY 2016

To browse the record layout, see the Downloads section below.

Please follow the instructions on the DUA - Limited Data Sets page.