Medicare CBSA Codes Database

Medicare Core-Based Statistical Areas

Our Medicare CBSA Codes database (Core-Based Statistical Areas) are commonly used to accurately file Medicare claims and to verify applicable incentives using a patient’s ZIP Code, such as the Medicare Home Health Rural Add-on Incentive.

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). To help make that determination, this database lists Medicare CBSA Codes, by county, and ZIP Code.

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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 known 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.

Layout

Due to the amount of data, the files are normalized to minimize the amount of duplicate information. The following files are included with this product:

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 / Watch our Accuracy Matters video

Database Specs

Data Format - CSV

Comma-Separated Values (CSV) Text File

ZIP Code

Official U.S. Postal Service five digit ZIP Code

City

Official city name used by the U.S. Postal Service

State Abbr.

Official U.S. Postal Service State Abbreviation

State

Official State Name

State FIPS

Federal Information Processing Standard (FIPS) 2‐digit state. FIPS codes are not available for all areas (APO, FPO, some U.S. Territories).

Medicare State Code

The state codes used in Medicare databases are Social Security Administration (SSA) codes, which differ from Federal Information Processing Standard codes (FIPS).

County

The name of the county in which the ZIP Code is found.

County FIPS

Federal Information Processing Standard (FIPS) 3‐digit county. FIPS codes are not available for all areas (APO, FPO, some U.S. Territories).

CBSA Medicare Code

(aka CMS CBSA) Geographic location code as defined by the Office of Management and Budget. Note: if the OMB makes a change after CMS has defined their codes, it won't show up until the next fiscal year.

CBSA Name

Geographic location name as defined by the Office of Management and Budget

CBSA Type

A CBSA sub-classification:
Micro - 10,000 to 50,000 population
Metro - 50,000 + population

Database Sources

We are licensees of USPS database products, but we enhance our CBSA Medicare database based on decades of experience to provide you with the most accurate product available.

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