Identifying and Classifying Medicaid Home and Community-Based Services Claims in the Transformed Medicaid Statistical Information System, 2016-2020

Identifying and Classifying Medicaid Home and Community-Based Services Claims in the Transformed Medicaid Statistical Information System, 2016-2020

Published: Sep 18, 2023
Publisher: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation
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Associated Project

Analyzing Medicaid’s T-MSIS Data to Inform Behavioral Health, Disability, and Aging Policy

Time frame: 2021 – 2026

Prepared for:

U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation

Authors

Jeral Self

Anna Pickrell

William Haltermann III

Judith Dey

Home and community-based services (HCBS) are a range of medical and non-medical services provided in the home and community that support individuals with functional limitations, enabling them to reside in the community rather than in institutional settings. Analyzing use of HCBS at the national level by type of service can be challenging due to variation in Medicaid coverage, codes used on claims, and terminology across states. To support analysis of Medicaid-funded HCBS use, this brief describes a methodology for identifying and classifying HCBS claims reported to the Transformed Medicaid Statistical Information System (T-MSIS) by service category.

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