Medicare CBSA Codes Database
Medicare CBSA (Core-Based Statistical Areas) Codes are used to accurately file Medicare claims and verify if the Medicare Home Health Rural Add-on incentive applies, based on a patient’s ZIP Code.
The Patient Protection and Affordable Care Act (PPACA) signed into law in early 2010 gives an additional 3% to payments made for home health services to patients in rural areas. To qualify for this incentive, a patient must live in a rural area indicated by Medicare CBSA Codes used by the Centers for Medicare & Medicaid Services (CMS).
Note: Regular CBSA’s differ from Medicare CBSA’s (CMS CBSA Codes)
Medicare CBSA (Core-Based Statistical Areas)
This product contains Medicare CBSA Codes, based on county, and assigned per ZIP Code for patient verification. If a ZIP Code crosses multiple counties, our file provides record for each occurrence.
Medicare uses CBSA codes that are not identical to standard CBSA Codes. They may also be know as 'CMS CBSA Codes' Although based on the same database, Medicare CBSA's insert exceptions and nuances regarding rural or smaller towns. Our database carefully implements these differences.
|Due to the amount of data, the files are normalized to minimize the amount of duplicate information. The following files are included:|
|med-cbsa-list-full||Contains CBSA code, CBSA Name, CBSA Type (‘Metro’ or ‘Micro’). Note: Medicare uses the Division code when a CBSA is part of a Division, therefore we include Division Codes and their Names anytime a CBSA is part of a Division. Example, rather than including 42660 for Seattle-Tacoma-Bellevue, our file will contain two records: 42644 (Seattle-Bellevue-Everett) and 45104 (Tacoma).|
|med-zip-cbsa-full||This file has one record for every ZIP Code and the corresponding CBSA / Division codes for that ZIP. Note: rural areas will have ‘999’ followed by a 2-digit Medicare state code (not the same as the FIPS code). Other fields include: State Abbreviation, State FIPs, City, County, and County FIPs. Military APO/FPO records, U.S. Virgin Islands and territories in the South Pacific are not included.|
|state-medicare||This is a master list of the 2-digit Medicare state code (not the same as the FIPS state code), standards USPS State Abbreviation, and State Name|
Learn more: view the CBSA Medicare Product Documentation
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