Glossary

Glossary

CMS terminology, acronyms, and column name conventions used throughout medicaid-utils.

Acronyms

Acronym	Full Name
CMS	Centers for Medicare & Medicaid Services
MAX	Medicaid Analytic eXtract (pre-2016 file format)
TAF	T-MSIS Analytic Files (2016+ file format)
T-MSIS	Transformed Medicaid Statistical Information System
ICD-9	International Classification of Diseases, 9th Revision
ICD-10	International Classification of Diseases, 10th Revision
CPT	Current Procedural Terminology
HCPCS	Healthcare Common Procedure Coding System
NDC	National Drug Code
NPI	National Provider Identifier
FQHC	Federally Qualified Health Center
FFS	Fee-For-Service
RUCA	Rural-Urban Commuting Area
RUCC	Rural-Urban Continuum Code
PCSA	Primary Care Service Area
ZCTA	ZIP Code Tabulation Area
PQI	Prevention Quality Indicator
BETOS	Berenson-Eggers Type of Service
CDPS	Chronic Illness and Disability Payment System
PMCA	Pediatric Medical Complexity Algorithm
OUD	Opioid Use Disorder
MAT	Medication-Assisted Treatment
HCRIS	Healthcare Cost Report Information System
UDS	Uniform Data System
ResDAC	Research Data Assistance Center

Column Name Conventions

MAX Files

Column	Description
MSIS_ID	State-assigned beneficiary ID (unique within state and year)
DIAG_CD_1 – DIAG_CD_9	Diagnosis codes
PRCDR_CD_1 – PRCDR_CD_6	Procedure codes
PRCDR_CD_SYS_1 – PRCDR_CD_SYS_6	Procedure coding system (1=CPT, 6=ICD-9, 7=ICD-10-PCS)
SRVC_BGN_DT, SRVC_END_DT	Service begin/end dates
ADMSN_DT, DSCHRG_DT	Admission/discharge dates (IP)
RCPNT_DLVRY_CD	Delivery recipient code
PLC_OF_SRVC_CD	Place of service code
EL_RSDNC_ZIP_CD_LTST	Beneficiary ZIP code (PS)

TAF Files

Column	Description
BENE_MSIS	Composite beneficiary ID constructed by medicaid-utils: STATE_CD-HAS_BENE-(BENE_ID or MSIS_ID)
DGNS_CD_1 – DGNS_CD_12	Diagnosis codes
ADMTG_DGNS_CD	Admitting diagnosis
PRCDR_CD_1 – PRCDR_CD_6	Procedure codes
LINE_PRCDR_CD	Line-level procedure code
SRVC_BGN_DT, SRVC_END_DT	Service begin/end dates
NDC	National Drug Code (pharmacy claims)
DAYS_SUPPLY	Prescription days of supply
BENE_ZIP_CD	Beneficiary ZIP code (DE)

Derived Columns (added by medicaid-utils)

Column	Description
LST_DIAG_CD	Comma-separated list of all diagnosis codes per beneficiary. MAX: must be constructed from DIAG_CD_* columns. TAF: created by gather_bene_level_diag_ndc_codes() on dct_files["base_diag_codes"]
LST_NDC	Comma-separated list of all NDC codes per beneficiary. TAF: created by gather_bene_level_diag_ndc_codes() on dct_files["line_ndc_codes"]
ed_use	1 if claim is an ED visit (any criterion)
ed_cpt	1 if ED identified via CPT codes (99281–99285)
ed_ub92	1 if ED identified via UB-92 revenue codes
ed_tos	1 if ED identified via Type of Service
ed_pos	1 if ED identified via Place of Service
excl_missing_dob	1 if date of birth is missing (used as exclusion filter)
excl_duplicated	1 if claim is a duplicate (used as exclusion filter)

CMS Data Resources

• ResDAC MAX Inpatient — MAX file documentation
• ResDAC TAF Inpatient — TAF file documentation
• ResDAC — Research Data Assistance Center
• Census FIPS Codes
• NBER SSA-FIPS Crosswalk