CMS Reports on Rates of Social Determinants of Health Coding on FFS Claims in 2017

January 28, 2020


CMS began collecting data on social determinants of health (SDOH) through the use of z-codes in 2016. The agency reported that among 33.7 million total Medicare FFS beneficiaries in 2017, approximately 1.4% had claims with Z codes. SDOH indicators are widely recognized as important predictors in clinical care and positive conditions are associated with improved patient outcomes and reduced costs.

The 5 most utilized Z codes in 2017 from Medicare FFS claims were:

  • Z590 – Homelessness
  • Z602 – Problems related to living alone
  • Z634 – Disappearance and death of family member
  • Z658 – Other specified problems related to psychosocial circumstances
  • Z630 – Problems in relationship with spouse or partner

Of the 467,136 Medicare FFS beneficiaries with Z code claims, 334,373 individuals (72%) had hypertension and 248,726 individuals (53%) had depression.

Z codes did not exist prior to the implementation of the ICD-10-CM codes in 2015. Their precursors in ICD-9 were V codes.



For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459 or

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