Chronic Conditions
Guidance for all stakeholders regarding prevalence and Medicare utilization and spending for 21 chronic conditions.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 27, 2019
Prevalence and Medicare utilization and spending are presented for the 21 chronic conditions listed below. Information is presented for (1) U.S. counties, (2) U.S. states, including Washington, DC, Puerto Rico, and the U.S. Virgin Islands, and is available for the years 2007-2018.
The data are available as Excel files.
| Alcohol Abuse | Drug Abuse/ Substance Abuse |
| Alzheimer’s Disease and Related Dementia | Heart Failure |
| Arthritis (Osteoarthritis and Rheumatoid) | Hepatitis (Chronic Viral B & C) |
| Asthma | HIV/AIDS |
| Atrial Fibrillation | Hyperlipidemia (High cholesterol) |
| Autism Spectrum Disorders | Hypertension (High blood pressure) |
| Cancer (Breast, Colorectal, Lung, and Prostate) | Ischemic Heart Disease |
| Chronic Kidney Disease | Osteoporosis |
| Chronic Obstructive Pulmonary Disease | Schizophrenia and Other Psychotic Disorders |
| Depression | Stroke |
| Diabetes |
Note: On October 1, 2015 the conversion from the 9th version of the International Classification of Diseases (ICD-9-CM) to version 10 (ICD-10-CM) occurred. Regardless of when a claim was submitted for payment, services that occurred prior to October 1, 2015, use ICD-9 codes. Chronic conditions identified in 2015 are based upon ICD-9 codes for the first ¾ of the year (January-September) 2015 and ICD-10 codes for the last quarter of the year (October-December). Starting in 2016, chronic conditions identified are based upon ICD-10 codes for the full year. Detailed information on the identification of chronic conditions in the CCW is available at http://www.ccwdata.org/chronic-conditions/index.htm.
Inquiries regarding this data can be sent to MedicareChronicConditions@cms.hhs.gov.
HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.