Provider Number
This variable is the provider identification number.
The first two digits indicate the state where the provider is located, using the SSA state codes; the middle two characters indicate the type of provider; and the last two digits are used as a counter for the number of providers within that state and type of provider (i.e., this is a unique but not necessarily sequential number).
Refer to CCW Technical Guidance document: "Getting Started with Medicare Data" for additional information regarding service setting classifications.
If you want additional information about the institutional provider, the quarterly CMS Provider of Services (POS) file contains dozens of variables that describe the characteristics of the provider. This file is updated quarterly, and effective May 2014 is available for free online from the CMS website (2005-current).
This variable is coded, and will contain one of the following values.
The following blocks of numbers are reserved for the facilities indicated (NOTE: may have different meanings dependent on the Type of Bill [TOB]): 0001-0879 Short-term (general and specialty) hospitals where TOB = 11X; ESRD clinic where TOB = 72X 0880-0899 Reserved for hospitals participating in ORD demonstration projects where TOB = 11X; ESRD clinic where TOB = 72X 0900-0999 Multiple hospital component in a medical complex (numbers retired) where TOB = 11X; ESRD clinic where TOB = 72X 1000-1199 Reserved for future use 1200-1224 Alcohol/drug hospitals (excluded from PPS-numbers retired) where
| Value | Description |
|---|---|
TOB |
11X; ESRD clinic where TOB = 72X 1225-1299 Medical assistance facilities (Montana project); ESRD clinic where |
TOB |
72X 1300-1399 Critical Access Hospitals (CAH) 1400-1499 Continuation of 4900-4999 series (CMHC) 1500-1799 Hospices 1800-1989 Federally Qualified Health Centers (FQHC) where TOB = 73X; SNF (IP PTB) where TOB = 22X; HHA where TOB = 32X, 33X, 34X 1990-1999 Religious Nonmedical Health Care Institutions (RNHCI) 2000-2299 Long-term hospitals 2300-2499 Chronic renal disease facilities (hospital based) 2500-2899 Non-hospital renal disease treatment centers 2900-2999 Independent special purpose renal dialysis facility (1) 3000-3024 Formerly tuberculosis hospitals (numbers retired) 3025-3099 Rehabilitation hospitals 3100-3199 Continuation of Subunits of Nonprofit and Proprietary Home Health Agencies (7300-7399) Series (3) 3200-3299 Continuation of 4800-4899 series (CORF) 3300-3399 Children's hospitals (excluded from PPS) where TOB = 11X; ESRD clinic where TOB = 72X 3400-3499 Continuation of rural health clinics (provider-based) (3975-3999) 3500-3699 Renal disease treatment centers (hospital satellites) 3700-3799 Hospital based special purpose renal dialysis facility (1) 3800-3974 Rural health clinics (free-standing) 3975-3999 Rural health clinics (provider-based) 4000-4499 Psychiatric hospitals 4500-4599 Comprehensive Outpatient Rehabilitation Facilities (CORF) 4600-4799 Community Mental Health Centers (CMHC) 4800-4899 Continuation of 4500-4599 series (CORF) 4900-4999 Continuation of 4600-4799 series (CMHC) 5000-6499 Skilled Nursing Facilities 6500-6989 CMHC / Outpatient physical therapy services where TOB = 74X; CORF where TOB = 75X 6990-6999 Numbers Reserved (formerly Christian Science) 7000-7299 Home Health Agencies (HHA) (2) 7300-7399 Subunits of 'nonprofit' and 'proprietary' Home Health Agencies (3) 7400-7799 Continuation of 7000-7299 series 7800-7999 Subunits of state and local governmental Home Health Agencies (3) 8000-8499 Continuation of 7400-7799 series (HHA) 8500-8899 Continuation of rural health center (provider based) (3400-3499) 8900-8999 Continuation of rural health center (free-standing) (3800-3974) 9000-9799 Continuation of 8000-8499 series (HHA) 9800-9899 Transplant Centers (eff. 10/1/07) 9900-9999 Reserved for future use NOTE: There is a special numbering system for units of hospitals that are excluded from prospective payment system (PPS) and hospitals with SNF swing-bed designation. An alpha character in the third position of the provider number identifies the type of unit or swing-bed designation as follows: |
M |
Psychiatric Unit in Critical Access Hospital |
R |
Rehabilitation Unit in Critical Access Hospital |
S |
Psychiatric unit (excluded from PPS) |
T |
Rehabilitation unit (excluded from PPS) |
U |
Swing-Bed Hospital Designation for Short-Term Hospitals |
V |
Alcohol drug unit (prior to 10/87 only) |
W |
Swing-Bed Hospital Designation for Long Term Care Hospitals |
Y |
Swing-Bed Hospital Designation for Rehabilitation Hospitals |
Z |
Swing Bed Designation for Critical Access Hospitals There is also a special numbering system for assigning emergency hospital identification numbers (non-participating hospitals). The sixth position of the provider number is as follows: |
E |
Non-federal emergency hospital |
F |
Federal emergency hospital |
Some additional information on this variable: