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The Outpatient file contains fee-for-service (FFS) claims submitted by institutional outpatient providers. Examples of institutional outpatient providers include hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, comprehensive outpatient rehabilitation facilities, Federally Qualified Health Centers and community mental health centers. The file includes facility charge amounts.

This file is based on information from the CMS form 1450 (UB04).

What does this file include? (variable highlights)

  • diagnosis (ICD diagnosis)
  • procedure (ICD procedure code)
  • Healthcare Common Procedure Coding System (HCPCS) codes, including CPT codes
  • dates of service
  • Medicare FFS reimbursement amount
  • Outpatient facility provider number 
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