Files for FY 2015 Final Rule and Correction Notice

All Excel files contain a text file for 508 compliance. Text files are 508 compliant by themselves.

1. FY 15 Impact File (Final Rule and Correction Notice): The impact file contains data elements by provider that were used in calculating the final FY 2015 rates and impacts. This file contains the final rule impact file issued August 2014 and an updated impact file that corresponds to the correction notice (CMS-1607-CN) issued October 2014.
2. AOR/BOR File: This zip file contains two excel spreadsheets, one for the After Outliers Removed (AOR) and one for the Before Outliers Removed (BOR). There are also two files 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.
3. Case Mix Index File: 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 2013, using the V30 Grouper).
4. HCRIS Data File: This zip file contains the SAS file of the March 31, 2014 quarterly update of the FY 2012 HCRIS (Healthcare Cost Report Information System (HCRIS), the database for the Medicare cost reports).  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 CCRs used in the calculation of the MS-DRG relative weights for the FY 2015 final IPPS are derived from the March 31, 2014 quarterly update of the FY 2012 HCRIS.  This zip file also includes 3 pdf files that are the HCRIS layout and other references needed to use the SAS file.
5. Standardizing File: This file is used to standardize charges for the rate building process.
6. County to CBSA Crosswalk File: This file contains a crosswalk of county codes to “Old CBSAs” and “New CBSAs”.
7. FY 2015 Final Rule Wage Index Public Use Files: Open Attached Zip file. Attached is a PDF with a description of each zip file. Main zip file contains 5 zip files:
   • FY 2015 Final Rule Wage Index PUFs; S3 Part II and Occ Mix Data
   • FY 2015 Final Rule Average Hourly Wage by Provider and CBSA Public Use File
   • FY 2015 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Occupational Mix Factor by Provider
   • FY 2015 Final Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
   • FY 2015 Final Rule AHW by Provider Area Listing
   • FY 2015 Final Rule Puerto Rico Specific Occupational Mix Adjusted and Unadjusted AHWs by Provider PUF
8. FY 2015 IPPS Hospital Readmissions Reduction Program Supplemental Data File (Final Rule and Correction Notice): This file contains both the proxy and final FY 2015 payment adjustment factors under the Hospital Readmissions Reduction Program and the number of cases and excess readmissions ratios for the five conditions (heart failure, pneumonia and acute myocardial infarction, chronic obstructive pulmonary disease and total hip/total knee arthroplasty) used to calculate the payment adjustment factors. In addition, it contains information on the number of cases for each of the applicable conditions excluded in the calculation of the readmission payment adjustment factors, and it contains DRG relative weight information to estimate the payment adjustment factors. Note, the final FY 2015 payment adjustment factors and supplemental information include the corrections from the October 2014 correction notice (CMS-1607-CN).
9. FY 2015 IPPS Medicare DSH Supplemental Data File (Final Rule and Correction Notice): This file contains the FY 2015 Factor 3 and data used to calculate Factor 3 to implement Section 3133 of the ACA, Improvements to Medicare DSH Payments. In addition, the file contains the data used for Medicare DSH estimates to support of the calculation of Factor 1. Lastly, the file contains a list of hospitals that have underwent a merger so the data of the merging hospitals has been combined to calculate the Factor 3 for the surviving hospital, as finalized in the FY 2015 IPPS Final Rule. The Factor 3 is the proportion of the uncompensated care amount that a DSH hospital will receive under the implementation of Section 3133 of the Affordable Care Act. For FY 2015, the Factor 3 is the hospital's Medicaid days and Medicare SSI days relative to all DSH hospitals Medicaid days and Medicare SSI days. DSH hospitals are identified as those hospitals that are projected to receive DSH for FY 2015. This file contains both the data issued with the final rule in August 2014 and the updated data reflecting the corrections from the October 2014 correction notice (CMS-1607-CN).
10. Definition of Medicare Code Edits: This file contains a description of each coding edit with corresponding ICD-9-CM code lists. There are two chapters in this file. The first chapter contains all the edits and the code lists for FY 2015. The second chapter summarizes, by edit, the changes in the edit code list from the last release of the MCE. This document is 508 compliant.
11. Table 1A-1E (Final Rule and Correction Notice): This excel spreadsheet contains the final rule and correction notice FY 2015 Operating and Capital National and Puerto Rico Specific Standardized Amounts.
12. FY 2015 Wage Index Tables (Final Rule and Correction Notice): Contains two zip files. One zip file with final rule and correction notice wage index tables using FY 2014 CBSA Delineations (Contains Tables 2-1, 3A-1, 3B-1, 4A-1, 4A-1 CN, 4B-1, 4B-1 CN, 4C-1, 4C-1 CN, 4D-1, 4D-1 CN, 4E-1, 4F-1, 9A-1, 9C-1). Second zip file contains final rule and correction notice wage index tables using FY 2015 CBSA Delineations (Contains Tables 2-2, 2-2 CN, 3A-2, 3B-2, 4A-2, 4A-2 CN, 4B-2, 4B-2 CN, 4C-2, 4C-2 CN, 4D-2, 4D-2 CN, 4E-2, 4F-2, 4J, 4J CN, 9A-2, 9C-2).
13. Table 5 (Final Rule and Correction Notice): The Excel file contains two tabs. The first tab contains the final rule MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay. The second tab contains the correction notice MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay. Note: Only the Geometric and Arithmetic Mean Length of Stay changed from the final rule to the correction notice.
14. Tables 6I-6K: Table 6I Complete MCC list; Table 6J Complete CC list; Table 6K Complete list of CC exclusions for the MS-DRGs
15. Tables 7A and 7B: Tables 7A and 7B contain the number of discharges, and selected percentile lengths of stay for both MS-DRGs, version 31 and MS-DRGs, version 32
16. Tables 8A, 8B, and 8C (Final Rule and Correction Notice): Contains the final rule Tables 8A and 8B FY 2015 IPPS operating and capital statewide average cost-to-charge-ratios. Also contains a revised Table 8B as discussed in the correction notice. Tables 8C contains the final FY 2015 LTCH statewide average cost-to-charge-ratios as published in the Federal Register
17. Table 10 (Final Rule and Correction Notice): Contains the final rule and correction notice cost thresholds by MS-DRG for the cost criteria for new technology add on payment applications for applications for FY 2016. Applicants should use the correction notice threshold for FY 2016 new technology add on payment applications.
18. Table 14: List of Hospitals with Fewer than 1,600 Medicare Discharges Based on the March 2014 Update of the FY 2013 MedPAR File and Potentially Eligible Hospitals’ FY 2015 Low-Volume Payment Adjustment for Discharges Occurring Before April 1, 2015 (Eligibility for the low-volume payment adjustment is also dependent upon meeting the mileage criteria specified at § 412.101(b)(2)(ii) of the regulations.)
19. Tables 15A and 15B (Final Rule and Correction Notice):  FY 2015 Readmissions Adjustment Factors.  Table 15A shows the proxy payment adjustment factors issued with the final rule in August 2014, which were provided for information purposes only.  Table 15B shows the final payment adjustment factors that will be used for making payments in FY 2015, and reflects the corrections from the October 2014 correction notice (CMS-1607-CN).   
20. Hospital Value-Based Purchasing (VBP) Program Tables 16A and 16B:
    • Table 16A: Contains updated proxy adjustment factors under the Hospital VBP Program that were calculated using historical baseline and performance periods. These proxies for the FY 2015 Hospital VBP payment adjustment factors will not be used to adjust hospital payments. This file includes the proxy adjustment factors published for the FY 2015 Final Rule (CMS-1607-F).
    • Table 16B: Contains the actual payment adjustment factors under the Hospital VBP Program for FY 2015. These actual factors are based on the finalized baseline and performance period for FY 2015 and will be used to adjust base operating DRG payments to eligible hospitals for discharges occurring in FY 2015.
21. Table 17: This file contains the hospital-level data for the Hospital-Acquired Condition (HAC) Reduction Program for FY 2015.
22. Table 18 (Final Rule and Correction Notice): FY 2015 Medicare DSH Uncompensated Care Payment Factor 3. This file contains the Medicare DSH Uncompensated Care Payment Factor 3 information.  This file contains both the final rule information issued August 2014 and an updated information that corresponds to the correction notice (CMS-1607-CN) issued October 2014.
23. Critical Access Hospitals Located in Counties That Will Lose Rural Status and Become Urban FY 2015