Relevant to: PDPS, MAOs
This memo is to notify Medicare Advantage Organizations (MAOs) about updates related to Provider Specific Files (PSFs) and the Inpatient Prospective Payment System (IPPS).
PSFs are maintained by the Medicare Administrative Contractors (MACs) and contain provider- specific information affecting computations for the IPPS for Medicare Fee-for-Service (FFS).
The data in these files are derived from CMS operational data and records used by CMS for operational purposes; CMS does not guarantee that the files are free from error or appropriate for purposes other than CMS’s own operations. These files are available for public use and we are aware that MAOs may use these PSFs to determine payments they make to hospitals. For several years prior to 2022, the contents of one particular field may have led to potential unintended payments made by plans.