Medicare HHRG Aggregate Table 2013

$179 / year

The dataset “HHRG Aggregate Table” contains information on utilization, Medicare payment, and submitted charges organized by HHRG.


The Home Health Agency PUF contains information on utilization, payment (Medicare payment and standardized payment), and submitted charges organized by Centers for Medicare and Medicaid Services (CMS) Certification Number (6-digit provider identification number), Home Health Resource Group (HHRG), and state of service. This PUF is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Home Health Agency PUF covers calendar year 2013 and contains 100% final-action (i.e., all claim adjustments have been resolved) home health agency institutional claims for the Medicare fee-for-service (FFS) population.

The spending and utilization data in the Home Health Agency PUF are aggregated to the following:
a) the identification number for the agency, and
b) the Home Health Resource Group (HHRG).

Medicare makes payment under the home health prospective payment system on the basis of a national standardized 60-day episode payment rate that is adjusted for the applicable case-mix and wage index. The national standardized 60-day episode rate includes the six home health disciplines (skilled nursing, home health aide, physical therapy, speech-language pathology, occupational therapy, and medical social services). To adjust for case-mix, patients are assigned to one of 153 home health resource groups (HHRG). The clinical severity level, functional severity level, and service utilization are used to place the patient in a particular HHRG. Each HHRG has an associated case-mix weight which is used in calculating the payment for an episode. For episodes with four or fewer visits, Medicare pays national per-visit rates based on the discipline(s) providing the services. An episode consisting of four or fewer visits within a 60-day period receives what is referred to as a low utilization payment adjustment (LUPA). For certain cases that exceed a specific cost threshold, an outlier adjustment may also be available.

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Last Modified




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Spatial Coverage

United States


John Snow Labs; Centers for Medicare and Medicaid Services;

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Medicare Payments, HHA Submitted Charges, Medicare Rate, Medicare Home, Medicare, Home Health Agency, Utilization and Payment Data

Other Titles

Medicare HHRG Aggregate Table Payment National Data 2013, Medicare Standardized Payment HHRG Aggregate Table 2013, Medicare HHRG Aggregate Table Utilization and Payment Data 2013, Medicare Home Health Resource Group Cost Data 2013

Home_Health_Resource_Group_CategoryHHRG category codestring-
Episode_TypeDescription of the HHRG categorystring-
TherapiesNumber of therapies receivedstring-
Clinical_Severity_LevelSeverity of the illness. Clinical severity is a Measure of disability of 3 levels, 3 being most severeintegerlevel : Ratio
Functional_Severity_LevelSeverity of physical function. Functional severity is a Measure of disability of 3 levels, 3 being most severeintegerlevel : Ratio
Service_Severity_Levelintegerlevel : Ratio
Total_EpisodesTotal count of episodes provided by a specific home health agency or in a unique HHRG category in the calendar yearintegerlevel : Ratio
Distinct_UsersNumber of distinct Medicare beneficiaries receiving at least one of home health episode in the calendar year. Beneficiaries may receive multiple home health episodes per year but are only counted once in this field.integerlevel : Ratio
Average_HHA_Charge_AmountAverage of the charges that the home health agency submitted for non-LUPA episodes.integerlevel : Ratio
Average_HHA_Medicare_Payment_AmountAverage amount that Medicare paid for non-LUPA episodes. Home health services do not have any cost-sharing requirements and the Medicare payment amount will equal the allowed amount.integerlevel : Ratio
3CFNLate Episode0-1331469568740663589
4BFMLate Episode14-1921398693345924578
4CFMLate Episode14-1931368165650695329
3AFLLate Episode0-131122005196721571774
3AFMLate Episode0-131136142581725182200
3AFNLate Episode0-131141766171628962621
3AFPLate Episode0-131155778521332703024
3AGLLate Episode0-131228958879224622087
3AGNLate Episode0-131249531916432092843
3AHLLate Episode0-131322952290126022297