Files for FY 2018 Final Rule and Correction Notice

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

1. FY 18 Final Rule Impact File (Final Rule and Correction Notice): This file contains data elements by provider that were used in calculating the FY 2018 rates and impacts for the FY 2018 final rule and correction notice.
2. AOR/BOR File (Final Rule and Correction Notice): This zip file contains 2 zip files, one for the FY 2018 Final Rule and one for the one for the FY 2018 Correction Notice. Each zip file contains one excel spreadsheet with multiple tabs: one for the After Outliers Removed (AOR) and one for the Before Outliers Removed (BOR). There are also two tabs 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 2016, using the V33 Grouper).
4. FY 2018 Final Rule: HCRIS Data File: 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 database for the Medicare cost reports is the Healthcare Cost Report Information System (HCRIS). The CCRs used in the calculation of the MS DRG relative weights for the FY 2018 IPPS Final Rule are derived from the March 31, 2017, quarterly update of the FY 2015 HCRIS. (HCRIS is updated on a quarterly basis). Note: this file is found in the Related Links section below.
5. Standardizing File (Final Rule and Correction Notice): This file contains two tabs, one for the FY 2018 Final Rule and one for the one for the FY 2018 Correction Notice. These files were used to standardize charges for the rate building process.
6. County to CBSA Crosswalk File and Urban CBSAs and Constituent Counties for Acute Care Hospitals File: This file contains two tabs: A crosswalk of county codes to CBSAs and a list of Urban CBSAs and Constituent Counties for Acute Care Hospitals Files (formerly Table 4E).
7. FY 2018 Final Rule Wage Index Public Use Files (Final Rule and Correction Notice): The Attached zip file contains 2 zip files, one for the FY 2018 Final Rule and one for the one for the FY 2018 Correction Notice. Each zip file contains a PDF with a description of each zip file. Each zip file contains 6 zip files:
   • FY 2018 Final Rule Wage Index PUFs; S3 Part II and Occ Mix Data
   • FY 2018 Final Rule Average Hourly Wage by Provider and CBSA Public Use File
   • FY 2018 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Occupational Mix Factor by Provider
   • FY 2018 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
   • FY 2018 Final Rule AHW by Provider Area Listing
8. FY 2018 IPPS Final Rule: Hospital Readmissions Reduction Program Supplemental Data File: This file contains the FY 2018 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, acute myocardial infarction, chronic obstructive pulmonary disease, total hip/total knee arthroplasty, and coronary artery bypass grafting) 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 MS DRG case-mix information to estimate the payment adjustment factors.
9. FY 2018 IPPS Final Rule: Medicare DSH Supplemental Data File (Final Rule and Correction Notice): This spreadsheet has 6 tabs which contains the following (Text files for each tab are included for Section 508 compliance): 
   • Tab 1: A File Layout for the spreadsheet. 
   • Tab 2: The final rule FY 2018 Factor 3 and data used to calculate Factor 3 to implement Section 3133 of the ACA, Improvements to Medicare DSH Payments.
   • Tab 3: A list of hospitals used in the final rule that have undergone a merger so that the data of the merged hospitals have been combined to calculate the surviving hospital’s Factor 3 for FY 2018.
   • Tab 4: The correction notice FY 2018 Factor 3 and data used to calculate Factor 3 to implement Section 3133 of the ACA, Improvements to Medicare DSH Payments.
   • Tab 5: A list of hospitals used in the correction notice that have undergone a merger so that the data of the merged hospitals have been combined to calculate the surviving hospital’s Factor 3 for FY 2018.
   • Tab 6 Data used for Medicare DSH estimates to support the calculation of Factor 1.
     
     Factor 3 in the second tab 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 2018, Factor 3 is the average of three individual Factor 3s. The individual Factor 3s for the first two years of the three year time period are based on the estimated number of Medicaid days and Medicare SSI days (or, for Puerto Rico a proxy of 14% of Medicaid days) relative to all DSH hospitals' estimated Medicaid days and Medicare SSI days. The individual Factor 3 for the third year of the three year time period is based on the hospital’s estimated uncompensated care costs relative to all DSH hospitals' estimated uncompensated care costs (or, for Puerto Rico, All Inclusive Rate Providers, and IHS/Tribal hospitals, the Factor 3 from the second year of the three year time period). For this purpose, DSH hospitals are identified as those hospitals that are projected to receive DSH payments for FY 2018.
10. Monthly Summary of Charges for Charge Inflation Factor: Excel spreadsheet contains two tabs. One has monthly charges by provider from April 2015 through March 2015. One has monthly charges by provider from April 2016 through March 2017.
11. Definition of Medicare Code Edits v35: The ICD-10 Definitions of Medicare Code Edits file contains the following: A description of each coding edit with the corresponding code lists as well as all the edits and the code lists effective for FY 2018. Zip file contains a PDF and text file that is 508 compliant.
12. ICD-10 MS-DRG Definitions Manual Files v35 (Updated September 11, 2017): A zip file with the ICD-10 MS DRG Definitions Manual (Text Version) contains the complete documentation of the ICD-10 MS-DRG Grouper logic. Note: For an explanation of updates, click on the Errata in the related links section.
13. ICD-10-CM/PCS MS-DRG v35 Definitions Manual Table of Contents - Full Titles - HTML Versions (Updated September 11, 2017): Click on the link in the "Related Links" section below to access the HTML Version of the Definitions Manual. Note: For an explanation of updates, click on the Errata in the related links section.
14. Table 1A-1E (Final Rule and Correction Notice): This excel spreadsheet contains the Final Rule and Correction Notice FY 2018 Operating and Capital National Standardized Amounts.
15. Tables 2 and 3 (Wage Index Tables; Final Rule and Correction Notice): Contains four tabs. Two for the final rule and two for the correction notice. Table 2- Case-Mix Index and Wage Index Table by CMS Certification Number (CCN); Table 3- Wage Index Table by CBSA.
16. Table 5 (Final Rule and Correction Notice): Contains two tabs. One for the final rule and one for the correction notice. List of Final MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay.
17. Tables 6A-6M and Tables 6P.1a-6P.4p (Final Rule and Correction Notice): Table 6A-New Diagnosis Codes; Table 6B-New Procedure Codes; Table 6C-Invalid Diagnosis Codes; Table 6D-Invalid Procedure Codes; Table 6E-Revised Diagnosis Code Titles; Table 6F-Revised Procedure Code Titles; Table 6G.1- Secondary Diagnosis Order Additions to the CC Exclusions List; Table 6G.2- Principal Diagnosis Order Additions to the CC Exclusions List; Table 6H.1- Secondary Diagnosis Order Deletions to the CC Exclusions List; Table 6H.2- Principal Diagnosis Order Deletions to the CC Exclusions List; Table 6I.- Complete MCC List; Table 6I.1- Additions to MCC List; Table 6I.2- Deletions to MCC List; Table 6J.- Complete CC List; Table 6J.1- Additions to CC List; Table 6J.2- Deletions to CC List; Table 6K.-Complete List of CC Exclusions; Table 6L.- Principal Diagnosis Is Its Own MCC List; Table 6M.- Principal Diagnosis Is Its Own CC List; Tables 6P.1a-6P.4p (ICD-10-CM and ICD-10-PCS Code Designations, MCE and MS-DRG Changes): See summary tab in excel spreadsheet called “CMS-1677-F TABLE 6P.1a-6P.4P.xlsx” for complete description of all tables. Note: Table 6P.4b is the only table that was updated due to the correction notice.
18. Tables 7A and 7B (Final Rule and Correction Notice): The Excel spreadsheet contains 3 tabs. Contains an updated version of table 7B due to the correction notice. Tables 7A and 7B contain the number of discharges, and selected percentile lengths of stay for both MS-DRGs, version 34 and MS-DRGs, version 35.
19. Tables 8A, 8B, and 8C: Tables 8A and 8B contain the final FY 2018 IPPS operating and capital statewide average cost-to-charge-ratios. Table 8C contains the final FY 2018 LTCH statewide average cost-to-charge-ratios
20. Table 10 (Final Rule and Correction Notice): This excel spreadsheet 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 2019.
21. Table 15:   FY 2018 Readmissions Adjustment Factors
22. 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 2018 Hospital VBP payment adjustment factors will not be used to adjust hospital payments. This file includes the proxy adjustment factors published for the FY 2018 Final Rule (CMS-1677-F).
    • Table 16B: Contains the actual payment adjustment factors under the Hospital VBP Program for FY 2018. These actual factors are based on the finalized baseline and performance period for FY 2018 and will be used to adjust base operating DRG payments to eligible hospitals for discharges occurring in FY 2018.
23. Table 18 (Final Rule and Correction Notice): Contains the FY 2018 final rule and correction notice Medicare DSH Uncompensated Care Payment Factor 3 and Projected DSH Eligibility.
24. CMS-1677-N Table 1: List of Hospitals with Fewer than 1,600 Medicare Discharges Based on the March 2017 Update of the FY 2016 MedPAR File and Potentially Eligible Hospitals’ FY 2018 Low-Volume Hospital Payment Adjustment. (Eligibility for the low-volume hospital payment adjustment is also dependent upon meeting the mileage criteria specified at § 412.101(b)(2)(ii) of the regulations.)
25. MAC Implementation File 1 – Certain FY 2018 IPPS factors, including applicable percentage increase, budget neutrality factors, High Cost Outlier (HCO) threshold, and Cost-of-Living adjustment (COLA) factors. Note: CMS released a correction notice on September 29, 2017. This file was updated September 29, 2017.
26. MAC Implementation File 2 - Certain FY 2018 LTCH PPS factors, including High Cost Outlier (HCO) threshold, and Cost-of-Living adjustment (COLA) factors.  Note: CMS released a correction notice on September 29, 2017. This file was updated September 29, 2017.
27. MAC Implementation File 3 - A list of hospitals that will receive the statutory reduction to the annual payment update for FY 2018 under the Hospital Inpatient Quality Reporting (IQR) Program.
28. MAC Implementation File 4 – LUGAR county list
29. MAC Implementation File 5 - Attachments 1 - 3 intended to assist the MACs in implementing the requirements of CR 10547, issued March 2, 2018.
30. MAC Implementation File 6 - IPPS hospitals with fewer than 1,600 Medicare discharges based on the March 2017 update of the FY 2016 MedPAR files.