Hospital Data Dictionary

RawRowID

A unique identifier for each row. This value in combination with the hospital_id should uniquely identify a record.

CreatedOn

The date and time that the MRF was extracted.

HospitalID

A UUID for a particular hospital that is unique for a particular year that the MRF is posted for. The same physical hospital will have 2 different hospital_id values for 2 different calendar years.

HospitalTemplateID

A persistent UUID for a particular hospital. Each year when a hospital posts a new MRF, this ID remains constant and allows for connecting the data extracted from MRFs over time.

HospitalName

The legal business name of the licensee. This value is the hospital_name obtained from within the MRF file.

LocationYM

The year and month (in YYYYMD format e.g. 202412) that the MRF file was last updated.

It uses the last_updated_on field if it is present within the file, otherwise it uses the date Serif Health processed the file.

HospitalAddress

The geographic address of the corresponding hospital location.

HospitalZip3

The zip3 of the hospital location.

Address information is internally reviewed and verified.

LastUpdatedOn

Date on which the MRF was last updated.

HospitalRegion

The state which the hospital location appears under on the CMS-HPT.txt file.

HealthSystemID

A UUID that allows tying together different hospitals belonging to the same health system.

HealthSystem

The name of the health system that the hospital belongs to.

Code

A standardized version of the "code" column available in the raw MRF. This value is cleaned using the code_type column.

RawCode

Any code used by the hospital for purposes of billing or accounting for the item or service. This value corresponds with the "code" column from the raw MRF.

CodeType

The corresponding coding type for the code data element. Example values: CPT, HCPCS, MS-DRG, APR-DRG, APC, RC, etc.

Setting

Indicates whether the item or service is provided in connection with an inpatient admission or an outpatient department visit. Valid values: "inpatient", "outpatient", "both".

Modifiers

Include any modifier(s) that may change the standard charge that corresponds to hospital items or services.

BillingClass

Allowed values: "professional", "institutional", "facility," and "both"

DrugUnitOfMeasurement

If the item or service is a drug, indicate the unit value that corresponds to the established standard charge.

DrugTypeOfMeasurement

The measurement type that corresponds to the established standard charge for drugs as defined by either the National Drug Code or the National Council for Prescription Drug Programs.

PayerName

A standardized version of the payer name. For example "UHC" will get standardized to "UnitedHealthcare".

If no standardized version is present, this will match the RawPayerName field.

RawPayerName

The name of the third-party payer that is, by statute, contract, or agreement, legally responsible for payment of a claim for a healthcare item or service.

Note: "Cash Pay" will appear in this column. This is the charge that applies to an individual who pays cash (or cash equivalent) for a hospital item or service.

CleanedPayerName

A standardized version of the payer name. For example, "UHC" will get standardized to "UnitedHealthcare".

PayerProduct

Valid values: HMO, EPO, PPO, POS, Medicare, Medicaid

Inferred from the payer_name or plan_name that appears on the MRF record.

PayerClass

Valid values: Commericial, Exchange, Military, Medicare, Medicaid

Inferred from the payer_name or plan_name that appears on the MRF record.

PlanName

The name of the payer's specific plan associated with the standard charge.

PayerNetworkRefID

An identifier for the raw_payer_name, plan_name, payer_class, and hospital_state represented on this row of data. This column is mostly intended for Serif Health internal use.

Description

Description of each item or service provided by the hospital that corresponds to the standard charge the hospital has established.

StandardGrossCharge

Gross charge is the charge for an individual item or service that is reflected on a hospital's chargemaster, absent any discounts.

NegotiatedRateDollar

Payer-specific negotiated charge (expressed as a dollar amount) that a hospital has negotiated with a third-party payer for the corresponding item or service.

NegotiatedRatePercentage

Payer-specific negotiated charge (expressed as a percentage) that a hospital has negotiated with a third-party payer for an item or service.

StandardChargeNegotiatedAlgorithm

Payer-specific negotiated charge (expressed as an algorithm) that a hospital has negotiated with a third-party payer for the corresponding item or service.

Count

Count of remittances used to calculate the allowed amounts. Allowed values are "0", "1 through 10", and whole numbers 11 and greater absent any thousands separator.

10thPercentile

Tenth (10th) percentile allowed amount means the 10th percentile of the total allowed amounts the hospital has historically received from a third party payer for an item or service for a time period no less than 12 months and no longer than 15 months prior to posting the machine-readable file.

EstimatedAmount

Estimated allowed amount means the average dollar amount that the hospital has historically received from a third party payer for an item or service. If the standard charge is based on a percentage or algorithm, the MRF must also specify the estimated allowed amount for that item or service.

90thPercentile

Ninetieth (90th) percentile allowed amount means the 90th percentile of the total allowed amounts the hospital has historically received from a third party payer for an item or service for a time period no less than 12 months and no longer than 15 months prior to posting the machine-readable file.

Methodology

Method used to establish the payer-specific negotiated charge. The valid value corresponds to the contract arrangement.

AdditionalPayerNotes

A free text data element used to help explain data in the file that is related to a payer-specific negotiated charge.

AdditionalGenericNotes

A free text data element that is used to help explain any of the data including, for example, blanks due to no applicable data, charity care policies, or other contextual information that aids in the public's understanding of the standard charges.

BaselineRate

The baseline rate for the given code, modifier, place of service, and billing class combination.

We update our baseline rate tables annually or quarterly by pulling the tables directly from CMS.

BaselineSchedule

A string indicating the baseline schedule used to generate the baseline_rate value.

By default, Serif Health uses the fields in each row to select the most appropriate CMS baseline schedule. IPPS, OPPS, Lab, Drug ASP, Anesthesia, and ASC schedules are supported and display their national payment amount for the billing code. For PFS, a MAC is selected baed on the hospital location, and the MAC value is used to set the baseline. If a MAC cannot be mapped, the PFS national payment amount value is used.

RelativeToBaseline

The ratio of the rate divided by the baseline. When the baseline is a CMS-dictated dollar payment amount, this column represents "percent of CMS" for the relevant BaselineSchedule. When the baseline is a weight, this column represents a "base rate" commonly used for negotiating inpatient or anesthesia pricing.

Decimal division of the rate by the baseline. If the baseline column is not populated for the given record, this column will be blank.

AcuteCareHospital

An indicator for nonfederal general acute care hospitals

Data source: AHRQ

HospitalBedCount

Count of total hospital beds reported in the CMS Healthcare Cost Report Information System (HCRIS) data.

Data source: AHRQ

AnnualDischargeCount

Count of total hospital discharges reported in the HCRIS data.

Data source: AHRQ

FTEIntern&ResidentCount

Count of total full-time-equivalent interns and residents reported in the HCRIS data.

Data source: AHRQ

Children'sHospital

A flag indicating that the hospital is identified as a children's hospital in the HCRIS data.

Data source: AHRQ

MajorTeachingHospital

Indicator that the hospital is a major teaching hospital, defined as a resident-to-bed ratio greater than or equal to 0.25.

Data source: AHRQ

VeryMajorTeachingHospital

Indicator that the hospital is a very major teaching hospital, defined as a resident-to-bed ratio greater than or equal to 0.60.

Data source: AHRQ

ResidentToBedRatio

Ratio of the number of residents to the number of beds at a hospital. A minor teaching system is typically defined as a resident-to-bed ratio greater than zero but less than 0.25.

Data source: AHRQ

HighDSHPatient%

High Disproportionate Share Hospital (DSH) patient percentage (top quintile among hospitals). A hospital is categorized as having a high DSH patient percentage if the value is in the top quintile among IPPS hospitals.

Data source: AHRQ

UncompensatedCareBurden

Uncompensated care burden is calculated as the ratio of uncompensated care to total operating expense.

Data source: AHRQ

HighUncompensatedCareBurden

A hospital is categorized as having a high uncompensated care burden if it is in the top quintile of uncompensated care burden among all hospitals in the data.

Data source: AHRQ

OwnershipType

Type of ownership reported in the HCRIS data. This is a categorical variable taking the following values: nonprofit=1, public/government=2, church-operated=3, and for-profit/investor owned=5.

Data source: AHRQ

NetPatientRevenue

Hospital's total patient revenue less contractual allowances and discounts on patients' accounts.

Data source: AHRQ

TotalPatientRevenue

Hospital's total patient revenue.

Data source: AHRQ

CorporateParentName

Corporate parent name.

Data source: AHRQ

CorporateParentType

Corporate parent type (health system or corporate owner).

Data source: AHRQ