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

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

NOTICE: Please note that as of April 2009, the OPPS Partial Hospitalization Program (PHP) Identifiable Data Set (IDS) is now considered a Limited Data Set (LDS).  The former identifiable version of the file is now the only version available.  The record layout below lists the data elements included on the new LDS, which are the same elements included in prior year versions of the IDS.  This file has every element that was contained in the 2007 LDS and the 2007 IDS.  Requestors should follow the link for Instructions on How to Request LDS Data Files below to obtain this file.

This file contains select claim level data and is derived from 2022 claims for partial hospitalization program (PHP) services and non-PHP OPPS hospital claims for similar services, with dates of service from January 1, 2022 - December 31, 2022 that were received, processed, and paid through June 30, 2023. Please refer to the CY 2024 OPPS/ASC final rule and the CY 2024 OPPS claims accounting for a full discussion of the trims and exclusion applied to the PHP and non-PHP 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 606,737 claims for PHP and non-PHP claims for similar services 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.

Media: DVD
Cost: $1,140

Data Format: CSV format with SAS® read-in program                                                              
Available: Final Rule 2024

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

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

Page Last Modified:
11/06/2023 10:10 AM