Medicaid Data Quality Atlas
This link from medicaid.gov includes dynamic lookup tools for data quality information that supports analyses using the T-MSIS Analytic Files (TAF) Research Identifiable Files (RIF) by topic and by state.
2016 Medicaid Data Overall Quality Snapshot (pdf) with easy to read chart on data quality.
2016 Medicaid Data Individual Quality Briefs and State Snapshots
Page Contents
DAC Medicaid Data Availability Spreadsheet
Note: Effective 7/1/2024 the DAC no longer supports new DUA submissions for Physical Data access.
Medicaid Data Dictionaries
Medicaid Enrollment Data
The Personal Summary File contains one record for every individual enrolled for at least one day during the year. The file contains demographic data (e.g. date of birth, gender, race), basis of eligibility, maintenance assistance status, monthly enrollment status, and a utilization summary. A small number of the records in the file are limited records for individuals who were assumed to be eligible, had a paid claim and then were ultimately determined to be ineligible.
This file contains one record for every individual eligible for and enrolled in Medicaid or CHIP for at least one day during the file calendar year. It includes eligibility dates, managed care enrollment, waiver enrollment, disability information, third party liability (TPL) information, and more.
Medicaid Claims Data
The Long Term Care File contains claims for institutional long term care services provided by Nursing Facilities, Intermediate Care Facilities (ICFs), and independent psychiatric facilities. Fields include facility type, dates of service, and discharge status. The MAX LT file contains 5 diagnosis codes and no procedure codes. Long term care provided under Home and Community Based Service waivers are found in the MAX OT file.
The Inpatient File contains complete stay records for enrollees who used inpatient services including diagnoses, procedures, discharge status, length of stay, and payment amount. The MAX Inpatient File contains 10 diagnostic fields and 7 procedure fields.
The Other Therapy File contains claim records for a variety of Medicaid services, including physician services, lab/X-ray, clinic services, home health, hospice and premium payments. Outpatient hospital institutional claims are also included in this file. As appropriate for the service utilization, the claims include diagnosis codes, procedure codes and date of service. The MAX OT file contains 2 diagnosis codes and 1 procedure code.
Medicaid MAX (Medicaid Analytic Extract) Prescription Drug (RX) file includes records of filled prescriptions from fee-for-service (FFS) claims paid by Medicaid and encounter records for prescription drugs paid by a Medicaid managed care organization.
This document describes the development and content of the TAF annual Demographic & Eligibility (DE) file. The TAF DE includes information on the demographic, eligibility, and enrollment characteristics of beneficiaries who were enrolled in Medicaid or in CHIP for at least one day during any given calendar year.
The Medicaid and CHIP TAF (T-MSIS Analytic File) Inpatient (IP) file contains records for enrollees who had an inpatient hospital stay. Records include fee-for-service (FFS) claims, managed care encounters and supplemental payments for Medicaid, Medicaid-expansion CHIP and separate CHIP.
The Medicaid and CHIP TAF (T-MSIS Analytic File) Pharmacy (RX) file includes records of filled prescriptions. Records include fee-for-service (FFS) claims, managed care encounters and supplemental payments for Medicaid, Medicaid-expansion CHIP and separate CHIP.
The Medicaid and CHIP TAF (T-MSIS Analytic File) Other Services (OT) file contains records for a variety of Medicaid services, including physician services, outpatient hospital institutional utilization, lab/X-ray, clinic services, home health, hospice and premium payments. Records include fee-for-service (FFS) claims, managed care encounters and supplemental payments for Medicaid, Medicaid-expansion CHIP and separate CHIP.
The Medicaid and CHIP TAF (T-MSIS Analytic File) Long Term Care (LT) file contains records for institutional long term care provided by specific facilities identified by the Type of Service variable:Nursing Facility Services; Mental Facility Services; Independent (free-standing) Psychiatric Wings of Acute Care Hospitals; Intermediate Care Facility (ICF) Services for Individuals With Intellectual Disabilities.