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Medicare Advantage Payment Rates Information
(Medicare+Choice; AAPCC)
2005 Medicare Advantage Rates
Cover Letter
Medicare Advantage Ratebook
- View rates online
- Demographic Factors
- Risk Factors:
-
Download ratebook2005.zip
(70K bytes) Zip archive expands to:
- rate2005.csv
- demofac.csv
- exhib1.csv
- exhib2.csv
- exhib3.csv
- exhib4.csv
- esrd1.csv
- esrd2.csv
- esrd3.csv
- esrd4.csv
- esrd5.csv
Rate calculation data
-
calculationdata2005.zip
(425K bytes) Zip archive expands to:
- AGED2005.csv
- DBLD2005.csv
- ESRD2005.csv
- RISK2005.csv
-
aga2005.zip
(209K bytes) Zip archive expands to:
- CalculationOfAGA.doc
- AGAAGED2005.csv
- AGADBLD2005.csv
- AGAESRD2005.csv
- AGARISK2005.csv
Preliminary Notice
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2004 Medicare Advantage Rates
Effective March - December
Cover Letter
Medicare Advantage Ratebook
- View rates online
- Demographic Factors
- Risk Factors: see Exhibits 1, 2, 3, and 4
-
Download ratebook2004b.zip
(64K bytes) Zip archive expands to:
- rate2004_revised.csv
- demofac.csv
- exhib1.csv
- exhib2.csv
- exhib3.csv
- exhib4.csv
Rate calculation data
-
calculationdata2004b.zip
(499K bytes) Zip archive expands to:
- aged2004_revised.csv
- dsab2004_revised.csv
- esrd2004_revised.csv
- risk2004_revised.csv
- readme04b.txt
* * * * * Top of Page * * * * *
2004 Medicare+Choice Rates
Effective January - February ONLY
Cover Letter
Medicare+Choice Ratebook
- View rates online
- Demographic Factors: see Medicare Advantage Demographic Factors above
- Risk Factors: see Medicare Advantage Risk Factors above
-
Download ratebook2004.zip
(47K bytes) Zip archive expands to:
- rate2004.csv
- demofac.csv
- exhib1.csv
- exhib2.csv
- exhib3.csv
- exhib4.csv
Rate calculation data
-
calculationdata2004.zip
(405K bytes) Zip archive expands to:
- aged2004.csv
- dsab2004.csv
- esrd2004.csv
- risk2004.csv
- readme04.txt
Preliminary Notice
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Historical Rates & Data
- USPCC Rates
- Historical Medicare Advantage, Medicare+Choice, and AAPCC Standardized Per Capita Rates of Payment and Rate Calculation Data
- Announcement of Calendar Year (CY) 2003 Medicare+Choice Payment Rates (03/01/2002)
- Advance Notice of Methodological Changes for Calendar Year (CY) 2002 Medicare+Choice (M+C) Payment Rates (01/12/2001)
- Announcement of Calendar Year (CY) 2001 Medicare+Choice Payment Rates (03/01/2001)
- Announcement of Calendar Year (CY) 2001 Medicare+Choice Payment Rates (03/01/2000)
- Advance Notice of Methodological Changes for Calendar Year (CY) 2001 Medicare+Choice (M+C) Payment Rates (01/15/2000)
- Announcement of Calendar Year (CY) 2000 Medicare+Choice Payment Rates (03/01/1999)
- Advance Notice of Methodological Changes for the CY 2000 Medicare+Choice Payment Rates (01/15/1999)
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Risk Adjustment Information, Data files, & Programs
CMS-HCC Payment Model software and data for 2004
- Note to M+C Organizations Regarding ICD-9 Code Differences in Final CMS-HCC Risk Adjustment Model (Posted 07/17/03)
- hccsoftware.zip (49K bytes) This archive expands to 12 files. Read HCCsoft description.rtf (included in the archive) for further details and instructions.
-
avgrisk.zip
(36K bytes) This archive expands to:
- avgrisk.csv -- Estimated average county risk factors
- Additional data pertaining to the CMS-HCC model.
PIP-DCG payment model software and data for 2003
-
pipprogs2003.zip
(48K bytes) ( Note: revisions were made in the 3 files below in
October, 2002 to reflect the doubled CHF extra payment amount
for 2003) This archive expands to:
- PIPPROGS.TXT -- Documentation (revised October, 2002)
- PIPMODEL.TXT -- SAS Program Code (revised October, 2002)
- FMTPROG.TXT -- SAS Program Code (revised October, 2002)
-
icd-dxg.zip
(67K bytes) This archive expands to:
- ICD2DXG.CSV -- Crosswalk sorted by ICD codes
- DXG2ICD.CSV -- Crosswalk sorted by DxGroups
-
dxg-dcg.zip
(5K bytes) This archive expands to:
- DXG2DCG.CSV -- Crosswalk sorted by DxGroups
- DCG2DXG.CSV -- Crosswalk sorted by DCG categories
PIP-DCG payment model software and data for 2002
-
pipprogs2002.zip
(48K bytes) This archive expands to:
- PIPPROGS.TXT -- Documentation (revised November 29, 2001)
- PIPMODEL.TXT -- SAS Program Code (revised and updated January, 2001)
- FMTPROG2.TXT -- SAS Program Code (revised and updated January, 2001)
-
icd-dxg.zip
(67K bytes) This archive expands to:
- ICD2DXG.CSV -- Crosswalk sorted by ICD codes
- DXG2ICD.CSV -- Crosswalk sorted by DxGroups
-
dxg-dcg.zip
(5K bytes) This archive expands to:
- DXG2DCG.CSV -- Crosswalk sorted by DxGroups
- DCG2DXG.CSV -- Crosswalk sorted by DCG categories
PIP-DCG payment model software and data for 2000 and 2001
-
pipprogs2000.zip
(22K bytes) This archive expands to:
- PIPPROGS.TXT -- Documentation
- PIPMODEL.TXT -- SAS Program Code (revised and updated March 1999)
- FMTPROG.TXT -- SAS Program Code
- FMTXWALK.TXT -- DATA
-
icd-dxg.zip
(55K bytes) This archive expands to:
- ICD2DCG.CSV -- Crosswalk sorted by ICD codes
- DCG2ICD.CSV -- Crosswalk sorted by DCG codes
-
avgrisk.zip
(33K bytes) This archive expands to:
- AVGRISK.CSV -- Estimated average county risk factors
- Risk adjuster description (January 15, 1999 45-day notice)
* * * * * Top of Page * * * * *
Fee-for-Service Expenditure Data by County
- Cover Note (May 10, 2004)
-
ffs2002.zip
(476K bytes). Archive expands to:
- aged2002.csv
- dbld2002.csv
- esrd2002.csv
-
ffs2001.zip
(478K bytes). Archive expands to:
- aged2001.csv
- dbld2001.csv
- esrd2001.csv
-
ffs2000.zip
(526K bytes). Archive expands to:
- aged2000.csv
- dbld2000.csv
- esrd2000.csv
-
ffs1999.zip
(489K bytes). Archive expands to:
- aged1999.csv
- dbld1999.csv
- esrd1999.csv
-
ffs1998.zip
(489K bytes). Archive expands to:
- aged1998.csv
- dbld1998.csv
- esrd1998.csv
* * * * * Top of Page * * * * *
Reports
- Report to Congress: Proposed Method of Incorporating Health Status Risk Adjusters into Medicare+Choice Payments (March 1999, PDF Format, 492K bytes)
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Contact
- All questions on Medicare+Choice / AAPCC Payment Rates Information should be emailed to: dmmce@cms.hhs.gov. To expedite this process, please mention "Medicare+Choice/AAPCC" in your request.
* * * * * Top of Page * * * * *
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Last Modified on Thursday, September 16, 2004
Centers for Medicare & Medicaid Services