Free Network Build Assessment
Take it freeThe HSD Reference File is the authoritative document CMS uses to set time-distance thresholds for Medicare Advantage network adequacy. Here's exactly what it contains, how to read it, and how Blueprint loads it automatically.
The Health Service Delivery (HSD) Reference File is published annually by CMS as part of the Medicare Advantage and Part D application process. It defines the maximum allowable time-and-distance thresholds for each of the 22 required provider specialty categories, broken down by county and county classification (urban, suburban, rural).
Every Medicare Advantage organization filing a network adequacy submission uses the HSD Reference File as the basis for its analysis. A county-specialty pair is "adequate" if the plan can demonstrate that a sufficient number of providers of that specialty are located within the threshold time and distance for that county's classification.
The file is published as a series of Excel workbooks available through the CMS Health Plan Management System (HPMS). It contains:
CMS requires Medicare Advantage plans to demonstrate adequacy across 22 specialty categories. These span primary care, specialists, mental and behavioral health, and ancillary services. Key categories include:
The HSD Reference File is updated each October as part of the annual MA bid cycle. Updates typically include:
Plans that do not update their adequacy models to reflect the current benefit year's HSD Reference File will submit analyses against outdated thresholds — a filing error that CMS identifies during review and that triggers a deficiency notice.
Blueprint pre-loads the current benefit year's HSD Reference File thresholds for every state as part of the onboarding process. During Day 1 of onboarding, your Blueprint specialist confirms your state, LOB, and benefit year. The platform automatically applies the correct thresholds for every county in your service area — you do not need to manually extract, format, or enter data from the HSD file.
When CMS publishes the updated file each October, Blueprint applies the new thresholds automatically. Plans using Blueprint enter each new benefit year with thresholds already updated — no manual refresh required.
The most common errors related to the HSD Reference File that Blueprint sees in new client onboarding reviews:
Blueprint automates the network build workflows described in this article — from adequacy modeling to provider outreach tracking. See it with your state and line of business.