Files for FY 2017 Final Rule and Correction Notice

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

1. FY 17 Final Rule Impact File (Final Rule and Correction Notice): This file contains data elements by provider that were used in calculating the FY 2017 rates and impacts for the FY 2017 final rule and correction notice.
2. AOR/BOR File: This zip file for the FY 2017 final rule 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 2015, using the V32 Grouper).
4. FY 2017 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 2017 IPPS Final Rule are derived from the March 1, 2016 quarterly update of the FY 2014 HCRIS.  (HCRIS is updated on a quarterly basis). Note: this file is found in the Related Links section below.
5. Standardizing File: This file is 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 2017 Final Rule Wage Index Public Use Files: Open Attached Zip file. Attached is a PDF with a description of each zip file. Main zip file contains 6 zip files:
   • FY 2017 Final Rule Wage Index PUFs; S3 Part II and Occ Mix Data
   • FY 2017 Final Rule Average Hourly Wage by Provider and CBSA Public Use File
   • FY 2017 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Occupational Mix Factor by Provider
   • FY 2017 Final Rule Occupational Mix Adjusted and Unadjusted Average Hourly Wages and Pre-Reclass Wage Indexes by CBSA
   • FY 2017 Final Rule AHW by Provider Area Listing
8. FY 2017 IPPS Final Rule: Hospital Readmissions Reduction Program Supplemental Data File:  This file contains the FY 2017 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 2017 IPPS Medicare DSH Supplemental Data File (Final Rule and Correction Notice): This spreadsheet has 6 tabs. The first tab is the File Layout for the spreadsheet.  The second tab contains the final rule FY 2017 Factor 3 and data used to calculate Factor 3 to implement Section 3133 of the ACA, Improvements to Medicare DSH Payments. The third tab contains a list of hospitals that have undergone a merger so that the data of the merging hospitals have been combined to calculate the Factor 3 for the surviving hospital for FY 2017. The fourth tab contains the correction notice FY 2017 Factor 3 and data used to calculate Factor 3, and the fifth tab contains an updated list of hospitals that have undergone a merger so that the data of the merging hospitals have been combined to calculate Factor 3 for the surviving hospital for FY 2017. The sixth tab contains the data used for Medicare DSH estimates to support the calculation of the Factor 1. The Factor 3 in the fourth 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 2017, the Factor 3 is a hospital's share of Medicaid days and Medicare SSI days relative to all DSH hospitals’ Medicaid days and Medicare SSI days using cost report data from FYs 2011, 2012, and 2013 and SSI data from FYs 2012, 2013, and 2014. DSH hospitals are identified as those hospitals that are projected to receive DSH payments for FY 2017. Text files for each tab are included for Section 508 compliance.
10. Monthly Summary of Charges for Charge Inflation Factor: Excel spreadsheet contains two tabs. One has monthly charges by provider from April 2014 through March 2015. One has monthly charges by provider from April 2015 through March 2016.
11. FY 2017 Final Rule Office of the Actuary Estimate of Medicare Documentation and Coding Recoupment Adjustment
12. Definition of Medicare Code Edits v34:  Zip file contains two Folders with the Following PDFs:
    • ICD-9-CM Definitions of Medicare Code Edits for analyses purposes only.
    • ICD-10 Definitions of Medicare Code Edits.
      These files contain a description of each coding edit with the corresponding code lists. The ICD-10 Definitions of Medicare Code Edits file contains all the edits and the code lists effective for FY 2017. These documents are 508 compliant
13. ICD-9 and ICD-10 MS-DRG Definitions Manual Files v34: Zip file contains the following files:
    • A PDF that contains the ICD-9 MS DRG Definitions Manual for analyses purposes only
    • 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.
14. ICD-10-CM/PCS MS-DRG v34 Definitions Manual Table of Contents - Full Titles - HTML Versions: Click on the link in the "Related Links" section below to access the HTML Version of the Definitions Manual.
15. Table 1A-1E (Final Rule and Correction Notice): This excel spreadsheet contains the Final Rule and Correction Notice FY 2017 Operating and Capital National Standardized Amounts.
16. 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.
17. Table 5: List of MS-DRGs, Relative Weighting Factors and Geometric and Arithmetic Mean Length of Stay
18. Tables 6A-6J.2, 6K, 6L-6M.1 and 6P.1a-6P.4k (Final Rule and Correction Notice): For the correction notice, we updated Table 6B; all other tables (with a prefix of 6) from the final rule remain the same. Table 6A-New Diagnosis Codes; Table 6B-New Procedure Codes; Table 6C-Invalid Diagnosis Codes; Table 6D-Invalid Procedure Codes; Table 6E-Revised Diagnosis Codes Titles; Table 6F-Revised Procedure Codes 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 Major Complication and Comorbidity (MCC) List; Table 6I.1- Additions to MCC List; Table 6I.2- Deletions to MCC List; Table 6J- Complete Complication and Comorbidity (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 ; Table 6M.1- Additions to the Principal Diagnosis Is Its Own CC List ; Tables 6P.1a-6P.4k (FY 2017 ICD-10-CM and ICD-10-PCS Codes for MCE and MS-DRG Changes): See summary tab in excel spreadsheet called “CMS-1655- F TABLE 6P ICD-10-CM and ICD-10-PCS Codes for MCE and MS-DRG Changes.xlsx” for complete description of all tables.
19. Tables 7A and 7B: Tables 7A and 7B contain the number of discharges, and selected percentile lengths of stay for both MS-DRGs, version 33 and MS-DRGs, version 34
20. Tables 8A, 8B, and 8C: Tables 8A and 8B contain the FY 2017 IPPS operating and capital statewide average cost-to-charge-ratios. Table 8C contains the FY 2017 LTCH statewide average cost-to-charge-ratios.
21. Table 10 (Final Rule and Correction Notice): 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 2018.
22. Table 14: List of Hospitals with Fewer than 1,600 Medicare Discharges Based on the December 2015 Update of the FY 2015 MedPAR File and Potentially Eligible Hospitals’ FY 2017 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.)
23. Table 15:  FY 2017 Readmissions Adjustment Factors
24. 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 2017 Hospital VBP payment adjustment factors will not be used to adjust hospital payments. This file includes the proxy adjustment factors published for the FY 2017 Final Rule (CMS-1655-F).
    • Table 16B: Contains the actual payment adjustment factors under the Hospital VBP Program for FY 2017. These actual factors are based on the finalized baseline and performance period for FY 2017 and will be used to adjust base operating DRG payments to eligible hospitals for discharges occurring in FY 2017. NOTE: Table 16B displays the actual payment adjustment factors to a precision of 9 places to the right of the decimal; whereas, the hospital Percentage Payment Summary Reports display a precision of 10 places to the right of the decimal. Because Table 16B uses a different precision, the last places may vary due to rounding. Hospitals eligible for the Hospital VBP Program will have their payments adjusted in accordance to the full precision of 10 places to the right of the decimal as displayed on their Percentage Payment Summary Reports.
25. Table 18 (Final Rule and Correction Notice): Contains the FY 2017 final rule and correction notice Medicare DSH Uncompensated Care Payment Factor 3 and Projected DSH Eligibility