PSPA: Data Format
Two separate text data files are required during the PSPA data import process to ensure optimum performance: the Practice Procedure file and the Provider Patient Count file.
The Practice Procedure file usually contains one month of data, but this time period may also be user-defined.
The download data file must be an ASCII standard data formet (SDF) fixed-length text file (.txt file extension) with a Carriage Return and Line Feed characters <CR><LF> terminating each record.
Each field in each record will occupy the same number of bytes.
Practice Procedure File
|
View Data file layouts
|
| Data Element/Attributes |
Length
|
Type
|
Formatting
|
Required/
Optional
|
Provider Code
|
Up to 6 characters
(Columns 1-6)
|
Character
|
Left Justified
with trailing spaces
|
Required
|
A unique identifier assigned by a group practice that uniquely identifies a provider from all other providers at that practice.
|
Procedure Code
|
Up to 5 characters
(Columns 7-11)
|
Character
|
Left Justified
with trailing spaces
|
Required
|
An AMA CPT-4, State or practice "home-grown" procedure identifier that describes a service rendered.
|
Procedure Count
|
Up to 7 characters
(Columns 12-18)
|
Integer
|
Right Justified
with leading zeros.
|
Required
|
Represents the sum of all like procedures performed by a Provider for a given reporting period. May be a count of one (1) if a separate record is generated each time a procedure is performed by a Provider.
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Total Charges
|
Up to 7 characters
(Columns 19-25)
|
Integer
|
Right Justified
with leading zeros.
Round to nearest dollar; no decimal points,
no cents.
No negative dollars (charge backs)
|
Required
|
Represents the gross amount that is charged by a practice for a performed procedure.
|
Modifier
|
Up to 2 characters
(Columns 26-27)
|
Character
|
Space-fill for no entries or if not used by practice.
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Optional
|
A code identifying a special circumstance relating to the performance of a performed procedure.
|
Data contained in the Provider Patient Count and the Specialty Patient Count file must correspond to the same time period as data in the Practice Procedure file.
Provider Patient Count File
|
View Data file layouts
|
Data Element/
Attributes |
Length
|
Type
|
Formatting
|
Required/
Optional
|
| Provider Code |
Up to 6 characters
(Columns 1-6)
|
Character
|
Left Justified
with trailing spaces
|
Required
|
| A unique identifier assigned by a group practice that uniquely identifies a provider from all other providers at that practice. Each Provider Code in the Practice Procedure file must have a matching and corresponding Provider Code in the Provider Patient Count file. |
| Patient Count |
Up to 6 characters
(Columns 7-12)
|
Character
|
Right Justified
with leading spaces
|
Required
|
| The sum of unique patient encounters for a given month. Two Patient encounters at the same practice, with the same provider, in the same month counts as one Patient Count. Two patient encounters at the same practice with two different providers in the same month counts as two Patients Counts. This unique patient count is per provider. Note: Records with a patient count equal to zero should be ommitted from the patient count file. |
Specialty Visit Count File
|
View Data file layouts
|
Data Element/Attributes
|
Length
|
Type
|
Formatting
|
Required/
Optional
|
Specialty Code
|
Up to 3 characters
(Columns 1-3)
|
Character
|
Left Justified
with trailing spaces
|
Required
|
A unique identifier assigned by a group practice that identifies an area of medical specialization within that practice.
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Visit Count
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Up to 6 characters
(Columns 4-9)
|
Character
|
Right Justified
with leading spaces
|
Required
|
The sum of patient encounters per specialty for a given month. This differs from the Provider Patient Count in that the Provider Patient file tracks unique patient visits and the Specialty Patient Count file tracks every billable patient visit or encounter. Note: Records with a visit count equal to zero should be ommitted from the specialty visit count file.
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