Public Use Files (PUFs) are non-identifiable data that do not contain any protected health information (PHI) or personally identifiable information (PII). The Centers for Medicare & Medicaid Services (CMS) makes PUFs freely available for download.
Researchers who seek to use Research Identifiable File (RIF) data may find PUFs to be helpful resources. PUFs may be used to provide supplemental information and to help with project planning. ResDAC does not provide support for PUFs, and we are unable to answer questions related specifically to these files, however contact information for each dataset is provided on the specific data file page. See the following CMS open data websites for more information:
- https://data.cms.gov/ - Data on CMS Programs
- https://data.cms.gov/provider-data/ - Data on Medicare providers
- https://data.healthcare.gov/ - Data on the Marketplace
- https://data.medicaid.gov/ - Data on Medicaid and CHIP
Below are a few CMS public use files that researchers who use RIF data may find useful:
Synthetic Medicare Enrollment, Fee-for-Service Claims, and Prescription Drug Event
Synthetic datasets made up of realistic-but-not-real-data representing enrollment information and healthcare claims for 8,671 Medicare beneficiaries.
Researchers may find these datasets helpful to better understand the data layout and develop code prior to ordering or receiving research identifiable files.
List of ICD-10 CM and ICD-10 PCS Codes
CMS maintains and annually updates a list of ICD-10 CM (diagnosis) and ICD-10 PCS (procedure) codes. These codes are used to code services provided on or after Oct 1, 2015.
Researchers may find these datasets helpful in understanding CMS diagnostic and procedure codes. ICD-10 CM codes are present on all claims and are useful for identifying the reason for healthcare use and the presence of other conditions that may affect payment. ICD-10 PCS codes are present on inpatient claims and are useful for identifying major procedures which may affect payment of the claim.
List of CPT/HCPCS Codes
CMS maintains and annually updates a List of Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes (the Code List), which identifies all the items and services included within certain designated health services (DHS) categories or that may qualify for certain exceptions. CMS updates the Code List to conform to the most recent publications of CPT and HCPCS codes and to account for changes in Medicare coverage and payment policies. Code List updates for years 2022 and earlier were published in the Federal Register as an addendum to the annual Physician Fee Schedule final rule.
Researchers may find the list of CPT/HCPCS Codes helpful to identify services received in non- inpatient settings such as found in the Medicare outpatient and carrier files.
National Plan and Provider Enumeration System (NPPES)/National Provider Identifier (NPI) Downloadable File
CMS discloses NPPES health care provider data through a query-only database and a
downloadable file.
Researchers are often interested in a source that provides them with a list of all Medicare professional providers. The NPPES also includes taxonomy codes which provide information on the specialty or type of provider. These files can be linked with NPI variables on the Research Identifiable Files.
Provider of Services (POS) File - Hospital and Non-hospital Facilities
The Provider of Services (POS) File is a dataset that provides information on non-laboratory provider types including demographic information and the type of services provided.
Researchers may use the POS to identify type of ownership, bed size, teaching status, etc. POS data are organized by CMS Certification Number (CCN).
Healthcare Cost Reporting Information System (HCRIS)
Medicare-certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor (MAC). The cost report contains provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data.
The data consists of data elements included in the HCRIS extract created for CMS by the provider's Administrative Contractor.
Researchers may use the HCRIS to identify type of ownership, bed size, teaching status, urban/rural status, proportion of days billed to Medicare or Medicare, graduate medical education (GME) and disproportionate share hospital (DSH) payments. CMS has also developed a flat file for hospital cost reports which increases the ease of use. HCRIS data are organized by CMS Certification Number (CCN).