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The Medicare Inpatient (Encounter, Final File) contains Medicare Advantage plan paid records for inpatient hospital stays.

This file includes (variable highlights):

  • Admission, discharge dates
  • diagnosis (ICD diagnosis) codes
  • procedure (ICD procedure) codes
  • diagnostic related group (DRG) codes
  • patient discharge status code
  • organization NPI
  • Part C/Medicare Advantage benefit package and contract number
  • Revenue center codes, dates, unit counts
  • No payment variables are available
  • Encounter records submitted to CMS by September, 2020, for dates of service in CY 2018

Special considerations:

  • Many Medicare Advantage Plans offer extra coverage in addition to services covered under traditional fee-for-service Medicare (e.g., vision, hearing, dental, and/or health and wellness programs). Encounter data will include records for these additional items and services provided under the plan.

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