Medicare Claims File Data Elements (1991-Current)
File NameType of FileInformation Included
Denominator File Beneficiary enrollment information in a calendar year Beneficiary unique identifier, monthly entitlement indicators (A/B/Both), reasons for entitlement, state buy-in indicators, and monthly managed care indicators (yes/no)
Inpatient SAF Final action claims data submitted by inpatient hospital providers for reimbursement of facility costsICD-9 diagnosis and procedure codes, Diagnosis Related Groups (DRG�s), dates of service, and reimbursement amounts
Skilled Nursing Facility SAFFinal action claims data submitted by SNF providers ICD-9 diagnosis and procedure codes, dates of service, and reimbursement amounts
Outpatient SAF Final action claims data submitted by institutional outpatient providers ICD-9 diagnosis and procedure codes, CMS Common Procedure Coding System (HCPCS), dates of service, and reimbursement amounts
Home Health Agency SAF Final action claims data submitted by HHA providers Number of visits, type of visit (skilled-nursing care, home health aides, physical therapy, speech therapy, occupational therapy, and medical social services), ICD-9 diagnosis codes, dates of visits, and reimbursement amounts
Carrier SAF Final action claims data submitted by non-institutional providers ICD-9 diagnosis and procedure codes, CMS Common Procedure Coding System (HCPCS), dates of service, and reimbursement amounts
Hospice SAF Final action claims data submitted by Hospice providers Level of hospice care received (e.g., routine home care, inpatient respite care), ICD-9 terminal diagnosis, dates of service, and reimbursement amounts
Durable Medical Equipment Final action claims data submitted by Durable Medical Equipment suppliers ICD-9 diagnosis codes, services provided (CMS Common Procedure Coding System (HCPCS)), dates of service, and reimbursement amounts
MedPAR File Inpatient hospital and skilled nursing facility (SNF) final action stay records Inpatient "stay" record summarizes all services rendered to a beneficiary from the time of admission to a facility through discharge. Each record may represent one claim or multiple claims, depending on length of beneficiary's stay and amount of inpatient services used throughout stay