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The Medicare Skilled Nursing Facility (Encounter, Final File) includes Medicare Advantage plan paid records for skilled nursing facility stays. Skilled nursing care is the only level of nursing home care that is covered by the Medicare program.

 This file includes:

  • Diagnosis codes (ICD diagnosis)
  • Procedure codes (ICD procedure)
  • Resouce Utilization Group codes (RUGs)
  • Admission/discharge dates
  • Organization NPI number only
  • No payment variables
  • Part C/Medicare Advantage benefit package and contract number
  • 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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