The Centers for Medicare & Medicaid Services (CMS) requests Medicare Administrative Contractors (MACs) use a five digit county code for the purposes of implementing an out migration adjustment that used to be done manually. The county code will go on inpatient and outpatient Provider Specific Files (PSF). A Pricer will calculate appropriate wage index for a provider.

Full Transmittal: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/2017Downloads/R3712CP.pdf

Subject: New Fields in the Fiscal Intermediary Shared System (FISS) Inpatient and Outpatient Provider Specific Files (PSF)

Number: 3712

Title: Change Request 9926

Release Date: Feb. 3, 2017

Effective Date: July 3, 2017 – FY 2018 for the IPPS and for CY 2018 for the OPPS

Implementation Date: July 3, 2017

Special Notes: N/A