Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS
NOTICE: Please note that as of April 2009, the OPPS Partial Hospitalization Program (PHP) Identifiable Data Set (IDS) is now considered a Limited Data Set (LDS). The former identifiable version of the file is now the only version available. The record layout below lists the data elements included on the new LDS, which are the same elements included in prior year versions of the IDS. This file has every element that was contained in the 2007 LDS and the 2007 IDS. Requestors should follow the link for Instructions on How to Request LDS Data Files below to obtain this file.
As a result of the proposal to use cost report data with cost reporting periods prior to the COVID-19 Public Health Emergency (PHE) in CY 2023 OPPS ratesetting, there will be two PHP Limited Data Sets associated with the CY 2023 Proposed Rule.
The primary file contains select claim level data and is derived from 2021 claims for partial hospitalization program (PHP) services, with dates of service from January 1, 2021 - December 31, 2021 that were received, processed, and paid through December 31, 2021. The cost report data used in the ratesetting process for this file includes cost reporting periods prior to the PHE. This file includes data elements such as diagnosis codes, bill type, outlier payments, and service revenue payments. This file includes 21,553 claims for PHP services furnished by hospitals and community mental health centers (CMHCs) paid under the OPPS. This is a flat file. The LDS record length is 9,997, blocksize is 32,760.
The alternative file contains select claim level data and is derived from 2021 claims for partial hospitalization program (PHP) services, with dates of service from January 1, 2021 - December 31, 2021 that were received, processed, and paid through December 31, 2021. The cost report data used in the ratesetting process for this file would use the standard cost report update, primarily cost reports beginning in CY 2020. This file includes data elements such as diagnosis codes, bill type, outlier payments, and service revenue payments. This file includes 20,848 claims for PHP services furnished by hospitals and community mental health centers (CMHCs) paid under the OPPS. This is a flat file. The LDS record length is 9,997, blocksize is 32,760.
The OPPS PHP file(s) will be available twice a year, once for the OPPS Proposed Rule in late spring/early summer, and again for the Final Rule within a month of publication of the OPPS Final Rule in the Federal Register.
Media: DVD
Cost: $1,140
Data Format: CSV format with SAS® read-in program
Available: Proposed Rule 2023
To browse the record layout, see the Downloads section below.
Please follow the instructions on the DUA - Limited Data Sets page.