Medicare Data

Medicare-Medicaid Data Sharing Program

The Medicare-Medicaid Data Sharing program, established by CMS-MMCO, is a free-of-charge process for state and territory Medicaid agencies to request timely access to certain Medicare data to coordinate the care of dually eligible beneficiaries and help ensure the integrity of the states’ and territories’ Medicaid programs.

For more information on the available Medicare data files, approved data uses, and options for analyzing these data, please see the Requesting and Using Medicare Data for Medicare-Medicaid Care Coordination and Program Integrity: An Overview document.

Claims data files contain records for each service paid for a given beneficiary, as well as extensive demographic and service-level identifiers. These data files will provide all data elements in Parts A and B claims.

Parts A and B Claims Data Files:

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Yearly, final action claims

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Monthly, non-final action claims

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Daily or Weekly, non-final action claims (enhanced, secondary Coordination of Benefits Agreement (COBA) data)

Claims and event data files contain records for each service paid for a given beneficiary, as well as extensive demographic and service-level identifiers. These data files will include the available Part D Prescription Drug Event (PDE) elements.

Part D PDE Data Files:

  1. Monthly, non-final action Part D PDE data
  2. Yearly, final-action Part D PDE data
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Yearly, final-action Part D PDE data

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Monthly, non-final action Part D PDE data

Summary data files contain summary measures on utilization, spending per year by beneficiary, and additional identifiers that allow users to analyze by population or service-type subgroup.

Summary Data Files:

  1. Master Beneficiary Summary File (MBSF)
  2. Medicare-MedicaidLinked Enrollee Analytic Data Source (MMLEADS)

Other Available Data Files:

  1. Crosswalks (BENE ID to HICN, BENE ID to SSN, and BENE ID to MBI)
  2. Medicaid Enrollee Supplemental File (MESF)
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Other Available Data Files

Attention

You are leaving the SDRC Public website and are being redirected to the new SDRC Portal website, where you can submit and track data requests, ask questions, and access SDRC resources. You will need a username and password to log into the SDRC Portal. If you are Medicaid agency staff and/or associated downstream user who would like access, please contact the SDRC Support Team for more information.

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