The CCW includes variables for 66 conditions – 27 common chronic conditions and 39 other chronic or potentially disabling conditions, which identify additional chronic health, mental health and substance abuse conditions. These variables are developed to facilitate researchers in the identification of cohorts of beneficiaries with specific conditions. Researchers may request data for a specific predefined cohort based on any of the categories on this page.

The condition variables are developed from algorithms that search the CMS administrative claims data for specific diagnosis codes, MS-DRG codes, or procedure codes. On October 1, 2015 the conversion from the 9th version of the International Classification of Diseases to version 10 occurred. Regardless of when a claim was submitted for payment, services that occurred prior to October 1, 2015, use ICD-9 codes.

All of the variables listed on this page are currently available in the Master Beneficiary Summary File (MBSF)Medicare-Medicaid Linked Enrollee Analytic Data Source (MMLEADS) and Medicaid Enrollee Supplemental File (MESF).

CCW Chronic Conditions

There are 27 chronic condition categories, available for file years 1999 - forward.

Original Version - 21 CCW Chronic Conditions for file years 1999-2010

This original version is no longer available, but listed here for reference purposes.  These conditions were in the previously available Beneficiary Annual Summary File (BASF).

Other Chronic Health, Mental Health, and Potentially Disabling Conditions

There are 39 other chronic health, mental health, substance abuse, and potentially disabling condition categories. These conditions are designed to enhance research of the Medicare-Medicaid dual enrolled population, however they are available for all non-dually enrolled Medicare and Medicaid beneficiaries as well.


Other Chronic or Potentially Disabling Conditions

 ADHD, Conduct Disorders, and Hyperkinetic Syndrome  Personality Disorders
 Alcohol Use Disorders  Post-Traumatic Stress Disorder (PTSD)
 Anxiety Disorders  Pressure and Chronic Ulcers
 Autism Spectrum Disorders  Schizophrenia
 Bipolar Disorder  Schizophrenia and Other Psychotic Disorders
 Cerebral Palsy  Sensory - Blindness and Visual Impairment
 Cystic Fibrosis and Other Metabolic Developmental Disorders  Sensory - Deafness and Hearing Impairment
 Depressive Disorders  Spina Bifida and Other Congenital Anomalies of the Nervous System
 Drug Use Disorders  Spinal Cord Injury
 Epilepsy  Tobacco Use
 Fibromyalgia, Chronic Pain and Fatigue  Traumatic Brain Injury and Nonpsychotic Mental Disorders due to Brain Damage
 Human Immunodeficiency Virus and/or Acquired Immunodeficiency Syndrome (HIV/AIDS) *  Viral Hepatitis (General), including:
  • Hepatitis A
  • Hepatitis B (acute or unspecified)
  • Hepatitis B (chronic)
  • Hepatitis C (acute)
  • Hepatitis C (chronic)
  • Hepatitis C (unspecified)
  • Hepatitis D
  • Hepatitis E
 Intellectual Disabilities and Related Conditions
 Learning Disabilities
 Leukemias and Lymphomas
 Liver Disease, Cirrhosis and Other Liver Conditions
 Migraine and Chronic Headache
 Mobility Impairments
 Multiple Sclerosis and Transverse Myelitis
 Muscular Dystrophy
 Opioid Use Disorder
 Other Developmental Delays
 Peripheral Vascular Disease (PVD)

* There are also variables that measure care (largely Medicaid services) provided to individuals with HIV/AIDS. These variables are not included in the Master Beneficiary Summary File (MBSF) or Medicaid Enrollee Supplemental File (MESF).