MEDPAR Limited Data Set (LDS) - Hospital (National)

MedPAR consolidates Inpatient Hospital or Skilled Nursing Facility (SNF) claims data from the National Claims History (NCH) files into stay level records.   The accumulation of claims submitted for the period commencing on a beneficiary's date of admission to an inpatient hospital or SNF and ending on the beneficiary’s date of discharge from that hospital or SNF represents one stay.  In the case of a SNF stay where the beneficiary has not yet been discharged and remains a patient, the claims submitted between the admission date to the SNF through the time of the MedPAR file creation, represent one stay. A stay record may represent one or more final action claims.  

NOTE:  Any given MedPAR file represents a static snapshot of a specific stay at the time the data was sourced from NCH.  As such, any given stay record on a specific update of MedPAR DOES NOT NECESSARILY represent the final coding and/or payment information for that stay because if subsequent adjustments to the claims that comprise the stay occur after MedPAR is run, they will not be reflected on the file.

We also note that Maryland hospitals were not required to report present-on-admission conditions until October 2014. Users should exercise caution using Maryland MedPAR data alone to evaluate quality of care. For additional information regarding Maryland hospitals, please see the Maryland All Payer Model and Maryland Health Services Cost Review Commission links under Additional Information below.

Data Alert 2022: The LDS MedPAR layout has been revised for the FY2022 Update. See the ‘FY2022_MedPAR_Version_L3K_Layout’ in the ‘Downloads’ section for detailed information. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been appended to the MEDPAR LDS – Inpatient File.

Data Alert 2021: The LDS MedPAR layout has been revised for the FY2021 Update. See the ‘FY2021_MedPAR_Version_L3K_Layout’ in the ‘Downloads’ section for detailed information. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been appended to the MEDPAR LDS – Inpatient File.

Data Alert 2020: As discussed in section II.A. of the preamble of the FY 2022 IPPS/LTCH proposed rule, CMS proposed to use the FY 2019 data for the FY 2022 IPPS and LTCH PPS ratesetting for circumstances where the FY 2020 data is significantly impacted by the COVID-19 public health emergency.  In addition, CMS considered an alternative approach of using the data we would ordinarily use in the FY 2022 IPPS and LTCH PPS rate setting, such as the FY 2020 MedPAR file (which is discussed in section I.O. of Appendix A of the FY 2022 IPPS/LTCH proposed rule). Two files are included, the FY 2020 MedPAR file (December 2020 update) and the updated FY 2019 MedPAR file used to develop the FY 2022 IPPS/LTCH PPS proposed rule. Both of these files contain the proposed V39 MS-DRG groupings.

Data Alert 2019: The LDS MedPAR layout has been revised for the FY2019 Update. See the ‘FY2019_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The fields for ‘Claim Model Reimbursement Amount’, ‘Revenue Center Model Reimbursement Amount’, and ‘Value Code QB OCM+ Payment Adjustment Amount’ have been added to the file. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been appended to the MEDPAR LDS – Inpatient File.

Data Alert 2018: The LDS MedPAR layout has been revised for the FY2018 Update. See the ‘FY2018_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been appended to the MEDPAR LDS – Inpatient File.

Data Alert 2017: The LDS MedPAR layout has been revised for the FY2017 Update. See the ‘FY2017_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been appended to the MEDPAR LDS – Inpatient File

Data Alert 2016: The LDS MedPAR layout has been revised for the FY2016 Update. See the ‘FY2016_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The fields for ‘Accountable Care Organization (ACO) Identification Number’, ‘Revenue Center Allogeneic Stem Cell Acquisition/Donor Services’, and ‘Islet Add-On Payment Amount’ have been added to the file. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been appended to the MEDPAR LDS – Inpatient File.

Data Alert 2015: The LDS MedPAR layout has been revised for the FY2015 Update. See the ‘FY2015_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The field for ‘IPPS Flex Payment 6 Amount’ has been replaced by ‘HAC Reduction Payment Amount’. The fields for ‘Site Neutral Payment Based on Cost Amount’, ‘Site Neutral Payment Based on IPPS Amount’, ‘Full Standard Payment Amount’, ‘Short Stay Outlier (SSO) Payment Amount’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 1 Code’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 2 Code’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 3 Code’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 4 Code’, ‘Next Generation (NG) Accountable Care Organization (ACO) Indicator 5 Code’, ‘Residual Payment Indicator Code’, ‘Claim Representative Payee (RP) Indicator Code’, and ‘Revenue Center Representative Payee (RP) Indicator Code’ have been added to the file. The fields for ‘LTCH Standard Pay Case’ and ‘Previous ICU Days’ have been appended to the MEDPAR LDS – Inpatient File.

Data Alert 2014: The LDS MedPAR layout has been revised for the FY2014 Update. See the ‘2014_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The field position for ‘Bundled Model Discount Percent’ has been updated and has subsequently changed the positions of all fields starting on and after position 1634. The fields for ‘EHR Payment Adjustment Amount’, ‘PPS Standard Value Payment Amount’, ‘Final Standard Amount’, ‘IPPS Flex Payment 6 Amount’, ‘IPPS Flex Payment 7 Amount’, Patient Add-On Payment Amount’, ‘HAC Program Reduction Indicator Switch’, ‘EHR Program Reduction Indicator Switch’, ‘Prior Authorization Indicator Code’, ‘Unique Tracking Number’, and ‘2 Midnight Stay Indicator Switch’ have been added to the file.

Data Alert 2013: The LDS MedPAR layout has been revised for the FY2013 Update. See the ‘2013_MedPAR_Version_R2K_Layout’ in the ‘Downloads’ section for detailed information. The field positions for ‘VBP Adjustment Percent’ and ‘HRR Adjustment Percent’ have been updated and have subsequently changed the positions of all fields starting on and after position 1636. The fields for ‘Sequestration Reduction Amount’, ‘Uncompensated Care Payment Amount’, ‘Bundled Adjustment Amount’, ‘VBP Adjustment Amount’, and ‘HRR Adjustment Amount’, have been added to the file.

Data Alert 2012: The LDS MedPAR layout has been revised for the FY2012 Update. See the ‘2012_MedPAR_Version_R2K_Layout‘ in the ‘Downloads’ section for detailed information. Additionally, the logic for the assignment of the ‘MEDPAR NCH Claim Type Code' has been updated for the FY2012 release. 

Data Alert 2011: CMS is aware of an issue in the ‘MEDPAR NCH Claim Type Code' field in MedPAR, beginning in the January 2011 update.  The issue results in the assigning of claim type code ‘61’ where ‘62’ or ’64’ may be more appropriate.

CMS is working with technical staff in order to correct the logic and expects that future releases of the MedPAR will incorporate the updated logic.

Data Alert 2010:  CMS systems have been transitioning to a format that accommodates ICD-10 codes as well as 'E' codes, both in greater occurrences.  In the process of creating the December 2010 update of the FY2010 MedPAR, claims were converted to the new format and then reconverted to the older format. In that conversion process, POA codes associated with additional E codes carried on the newer format populated the 10^th position of the POA string in some records.  For research purposes, values in the 10^th position of the POA string should be disregarded.

The MEDPAR LDS is identical to the Expanded Modified MEDPAR.

The Medicare Provider Analysis and Review (MEDPAR) file contains records for 100% of Medicare beneficiaries who use hospital inpatient services. The records are stripped of most data elements that will permit identification of beneficiaries. The six positions Medicare billing number identifies the hospital. The file is available to persons qualifying under the terms of the Routine Use Act as outlined in the December 24, 1984, "Federal Register" and amended by the July 2, 1985, Notice. The national file consists of approximately 15 million records.

NOTE:  CMS will release the Expanded Modified MEDPAR based on the IPPS proposed rule on the date of the rule publication.   The fiscal year of the proposed rule Expanded Modified MEDPAR will use the December update of the MEDPAR from the second preceding fiscal year (i.e., the FY 2010 proposed rule uses the December update to the FY 2008 MedPAR)

1. The Notice of Proposed Rule Making (NPRM) is published in the "Federal Register", usually available in April. This file is derived from the MEDPAR file with a cutoff of three months after the end of the fiscal year (December file).
2. The Final Rule is published in the Federal Register usually by the first week of August. This file is derived from the MEDPAR file with a cutoff of six months after the end of the fiscal year (March file).

Media: DVD  

File Cost: $3,600.00 per year  

Data Format:  Comma separated variable block with SAS® read-in program

Available:  FY 2002 through FY 2023

Note: Regarding the 1999 File – The file contains corrupted data in data element "Admission of Date of Death Interval" positions 528-532. Corruption occurred during the Y2K conversion of legacy data files. At present, there are no plans to correct the data.

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

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