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This variable is contained in the following files:
SAS Name
PRVDR_NUM
This variable is the provider identification number.
The first two digits indicate the state where the provider is located, using the SSA state codes; the middle two characters indicate the type of provider; and the last two digits are used as a counter for the number of providers within that state and type of provider (i.e., this is a unique but not necessarily sequential number).
The following are the last four digits of the provider number; the blocks of numbers classify the facilities:
| Code | Code value |
|---|---|
| 0001-0879 | Short-term (general and specialty) hospitals where Type of bill (TOB) = 11X; ESRD clinic where TOB = 72X |
| 0880-0899 | Reserved for hospitals participating in ORD demonstration projects where TOB = 11X; ESRD clinic where TOB = 72X |
| 1300-1399 | Critical access hospitals (CAH) |
| 1990-1999 | Religious Nonmedical Health Care Institutions (RNHCI) |
| 2000-2299 | Long-term hospitals |
| 3025-3099 | Rehabilitation hospitals |
| 3300-3399 | Children's hospitals (excluded from PPS) where TOB = 11X; ESRD clinic where TOB = 72X |
| 4000-4499 | Psychiatric hospitals |
| 5000-6499 | Skilled nursing facilities |
If you want additional information about the institutional provider, the quarterly CMS Provider of Services (POS) file contains dozens of variables that describe the characteristics of the provider. This file is updated quarterly, and effective May 2014 is available for free online from the CMS website (2005– current).
There is a special numbering system for units of hospitals that are excluded from prospective payment system (PPS) and hospitals with SNF swing-bed designation. Starting in 2021, an alpha character in the third position of the provider number identifies the category of institutional provider that furnished services to the beneficiary during the stay. This applies to IPPS hospitals, critical access hospitals, and IPPS-excluded hospitals with IPPS-excluded rehabilitation or psychiatric units or swing beds (as applicable) as follows:
U = Swing-bed hospital designation for short-term hospitals
W = Swing-bed hospital designation for long-term care hospitals
Y = Swing-bed hospital designation for rehabilitation hospitals
Z = Swing bed designation for critical access hospitals
There is also a special numbering system for assigning emergency hospital identification numbers (nonparticipating hospitals).
The sixth position of the provider number is as follows:
E = Non-federal emergency hospital
F = Federal emergency hospital
Starting in 2021, the PRVDR_BASE_FAC_CCN_NUM is populated with CCN of the parent provider for IPPS hospitals, critical access hospitals, and IPPS-excluded hospitals with IPPS-excluded rehabilitation or psychiatric units or swing beds (as applicable). Beginning in 2021, the PRVDR_NUM may contain an alpha character in the third digit, which is recoded when it appears in the PRVDR_BASE _FAC_CCN_NUM as follows:
Where position 3 is an alpha character (S, T, U, W, or Y) replace with a “0”.
Where position 3 is an alpha character (M or R) replace with a “1”.
Source: NCH