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Special Programs/Initiatives - Long Term Care Facility Staffing Payroll-Based Journal
Dataset
Payroll-Based Journal staffing data submitted by long term care facilities. Data are presented as one row per work day, for each facility.
Tags No tags assigned
API Docs
Created
April 14 2021
Views
76

Special Programs/Initiatives - Long Term Care Facility Staffing Payroll-Based Journal
Dataset
Payroll-Based Journal staffing data submitted by long term care facilities. Data are presented as one row per work day, for each facility.
Tags No tags assigned
API Docs
Created
April 14 2021
Views
26

Dataset
List of Providers in Medicare specializing in Home Infusion Therapy
Tags No tags assigned
API Docs
Created
March 19 2021
Views
884

Dataset
Updated ACS data including year 2019
Tags No tags assigned
API Docs
Created
February 2 2021
Views
127

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2020 report period (claims submitted July 1, 2018 through June 30, 2019). These claims were used to calculate the FY 2020 Medicare FFS improper payment rate.

The Comprehensive Error Rate Testing (CERT) program’s public data contains the claims reviewed from the Medicare Fee-for-Service (FFS) universe for each reporting period. To minimize the risk of beneficiary identification of each claim, Healthcare Common Procedure Coding System (HCPCS) codes that are considered rare (defined as having 10 or fewer claims in the Medicare FFS universe for the reporting period) are removed from the public data for each reporting period. Additionally, a service that is provided by a singular provider or supplier can be removed from the public data dependent upon stakeholder feedback.
Tags improper payment cert medicare comprehensive error rate testing fee-for-service
API Docs
Created
January 21 2021
Views
632

Dataset
This list includes all Medicare enrolled Ambulatory Surgical Centers that converted to Hospitals or Independent Free Standing Emergency Departments enrolled as Hospitals during the COVID-19 public health emergency
Tags No tags assigned
API Docs
Created
January 21 2021
Views
412

Medicare
Dataset
The MCBS COVID-19 Fall 2020 Supplement is a nationally representative, cross-sectional telephone survey of persons who were continuously enrolled in Medicare from the beginning of 2020 and alive and living in the community in Fall 2020, fielded from October 5, 2020 through November 15, 2020. These data are complemented by additional MCBS Community interview data already collected in Fall 2019 on beneficiaries’ health status and demographics as part of the in-person, nationally representative, longitudinal MCBS survey. The MCBS is sponsored by the Centers for Medicare & Medicaid Services (CMS) and directed by the Office of Enterprise Data and Analytics (OEDA).
ANALYTIC NOTE:
The Medicare Current Beneficiary Survey sample is designed to produce national estimates of the Medicare population. The use of the analytic weights in this PUF ensures that the estimates accurately reflect the Medicare population. Failure to use analytic weights provided in the PUF to analyze the data will result in estimates that may misrepresent characteristics of Medicare beneficiaries. For a full explanation of the use of survey weights on the Medicare Current Beneficiary Survey and analytic examples please see our tutorial on weighting and variance estimation located here: https://www.cms.gov/research-statistics-data-and-systemsresearchmcbsdata-briefs/mcbs-advanced-tutorial-weighting-and-variance-estimation. The PUF includes a full-sample weight (CPWFWGT) and a set of 100 replicate weights (CPWF001—CPWF100). The full-sample weight is the primary weight used to ensure that the Medicare population is appropriately represented when producing point estimates. The replicate weights are used for variance estimation under the Balanced Repeated Replication (BRR) method.
Tags covid-19 mcbs survey
API Docs
Created
January 14 2021
Views
180

Special Programs/Initiatives - Medicare Shared Savings Program (MSSP)
Dataset
The Medicare Shared Savings Program (Shared Savings Program) facilitates coordination among providers to improve the quality of care for Medicare fee-for-service beneficiaries while reducing the growth in health care costs. Eligible providers, hospitals, and suppliers may apply to participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO).
NOTE (1): Data descriptions are available in the Data Dictionary. See the Attachments section on this page to download the Data Dictionary.
NOTE (2): Excel may drop the leading zero from the ACO’s zip code in the aco_zip column when exporting the CSV file. To retain this information, we recommend using the “Import” feature of Excel to manually import the relevant data or exporting the file using one of the other supported file formats.
NOTE (3): The Spanish letter “ñ” may appear as “ñ” or a question mark when downloaded as a CSV file in some software versions. To retain the correct character, we recommend converting the file from CSV to a different format or opening in another software.
DISCLAIMER: This information is current as of January 1, 2021. Changes to ACO information occur periodically. Each ACO has the most up-to-date information about their organization. Consider contacting the ACO for the latest information.
Tags performance-based payment mssp value-based purchasing
API Docs
Created
January 12 2021
Views
566

Special Programs/Initiatives - Medicare Shared Savings Program (MSSP)
Dataset
The Medicare Shared Savings Program (Shared Savings Program) facilitates coordination among providers to improve the quality of care for Medicare fee-for-service beneficiaries while reducing the growth in health care costs. Eligible providers, hospitals, and suppliers may apply to participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO).
NOTE (1): Data descriptions are available in the Data Dictionary. See the Attachments section on this page to download the Data Dictionary.
NOTE (2): Excel may drop the leading zero from the ACO’s zip code in the aco_zip column when exporting the CSV file. To retain this information, we recommend using the “Import” feature of Excel to manually import the relevant data or exporting the file using one of the other supported file formats.
NOTE (3): The Spanish letter “ñ” may appear as “ñ” or a question mark when downloaded as a CSV file in some software versions. To retain the correct character, we recommend converting the file from CSV to a different format or opening in another software.
DISCLAIMER: This information is current as of January 1, 2021. Changes to ACO information occur periodically. Each ACO has the most up-to-date information about their organization. Consider contacting the ACO for the latest information.
Tags performance-based payment value-based purchasing mssp
API Docs
Created
January 12 2021
Views
3,178

Special Programs/Initiatives - Medicare Shared Savings Program (MSSP)
Dataset
The Medicare Shared Savings Program (Shared Savings Program) facilitates coordination among providers to improve the quality of care for Medicare fee-for-service beneficiaries while reducing the growth in health care costs. Eligible providers, hospitals, and suppliers may apply to participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO).
NOTE (1): Data descriptions are available in the Data Dictionary. See the Attachments section on this page to download the Data Dictionary.
NOTE (2): Excel may drop the leading zero from the ACO’s zip code in the aco_zip column when exporting the CSV file. To retain this information, we recommend using the “Import” feature of Excel to manually import the relevant data or exporting the file using one of the other supported file formats.
NOTE (3): The Spanish letter “ñ” may appear as “ñ” or a question mark when downloaded as a CSV file in some software versions. To retain the correct character, we recommend converting the file from CSV to a different format or opening in another software.
DISCLAIMER: This information is current as of January 1, 2021. Changes to ACO information occur periodically. Each ACO has the most up-to-date information about their organization. Consider contacting the ACO for the latest information.
Tags value-based purchasing mssp performance-based payment
API Docs
Created
January 11 2021
Views
3,909

Medicare - Clinical Laboratory Improvement Amendments (CLIA/lab)
Dataset
The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it is fairly large (156MB in CSV).
The POS Extract is created from the QIES (Quality Improvement Evaluation System) database. These data include provider number, name, and address and characterize the participating institutional providers. The data are collected through the Centers for Medicare & Medicaid Services (CMS) Regional Offices. The file contains an individual record for each Medicare-approved provider and is updated quarterly. For a list of provider types, layout files, and how to order previous annual files, please see the Source Link in the About tab.
Tags clia december 2020 pos provider of services
API Docs
Created
January 7 2021
Views
2,472

Medicare
Dataset
The POS file consists of two data files, one for CLIA labs and one for 18 other provider types. The file names are CLIA and OTHER. If downloading the file, note it is fairly large (156MB in CSV).
The POS Extract is created from the QIES (Quality Improvement Evaluation System) database. These data include provider number, name, and address and characterize the participating institutional providers. The data are collected through the Centers for Medicare & Medicaid Services (CMS) Regional Offices. The file contains an individual record for each Medicare-approved provider and is updated quarterly. For a list of provider types, layout files, and how to order previous annual files, please see the Source Link in the About tab.
Tags other pos provider of services december 2020
API Docs
Created
January 7 2021
Views
869

Medicare - Part D
Dataset
The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Medicare Part D Opioid Prescriber Summary File, which presents information on the individual opioid prescribing rates of health providers that participate in Medicare Part D program. This file is a prescriber-level data set that provides data on the number and percentage of prescription claims (includes new prescriptions and refills) for opioid drugs, and contains information on each provider’s name, specialty, state, and ZIP code. This summary file was derived from the 2018 Part D Prescriber Summary Table (Documentation available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Downloads/Prescriber_Methods.pdf)
Tags opioidmap prescriber opioid zip code 2018 and 1 more
API Docs
Created
January 7 2021
Views
739

Special Programs/Initiatives - Long Term Care Facility Staffing Payroll-Based Journal
Dataset
Payroll-Based Journal staffing data submitted by long term care facilities. Data are presented as one row per work day, for each facility.
Tags No tags assigned
API Docs
Created
January 4 2021
Views
650

Special Programs/Initiatives - Long Term Care Facility Staffing Payroll-Based Journal
Dataset
Payroll-Based Journal staffing data submitted by long term care facilities. Data are presented as one row per work day, for each facility.
Tags No tags assigned
API Docs
Created
January 4 2021
Views
1,122

Dataset
This list includes all Medicare providers that are currently enrolled as Mass Immunizers/Centralized flu billers.
Please download the Mass Immunizers Additional NPIs file for additional NPI information
Please join the Mass Immunizer file to the Additional NPIs file by enrollment id for complete results
Tags No tags assigned
API Docs
Created
December 17 2020
Views
1,375

Dataset
This dataset powers the search tool at https://data.cms.gov/utilization-and-payment
This should be public and hidden from catalog.
Tags No tags assigned
API Docs
Created
November 19 2020
Views
68

Medicare - Outpatient
Dataset
The Outpatient Hospital Utilization and Payment Public Use File (Outpatient Hospital PUF) presents information on comprehensive APC (C-APC) services provided to Medicare fee-for-service beneficiaries. The Outpatient Hospital PUF presents information on the number of beneficiaries, number of APC services, hospitals' average total estimated submitted charges, the average Medicare allowed charges (which includes Medicare regular provider payments and beneficiary cost-sharing payments), the average Medicare regular provider payments, the number of APC services with outlier payments, and the average Medicare outlier provider payments among those services for 60 C-APC Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2018 by hospital provider. The estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.
Tags mpup 2018 outpatient
API Docs
Created
November 17 2020
Views
302

Medicare - Part D
Dataset
The Part D Prescriber State Summary Report, Calendar Year 2018 provides information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program. The Part D Prescriber State Summary Report is based on information from CMS’s Chronic Conditions Data Warehouse, which contains Prescription Drug Event records submitted by Medicare Advantage Prescription Drug (MAPD) plans and by stand-alone Prescription Drug Plans (PDP). For each state and drug, the dataset includes the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost. The total drug cost includes the ingredient cost of the medication, dispensing fees, sales tax, and any applicable administration fees and is based on the amount paid by the Part D plan, Medicare beneficiary, government subsidies, and any other third-party payers.
Tags state 2018 mpup part d summary
API Docs
Created
November 12 2020
Views
262

Medicare - Part D
Dataset
The Part D Prescriber National Summary Report, Calendar Year 2018 provides information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program. The Part D Prescriber National Summary Report is based on information from CMS’s Chronic Conditions Data Warehouse, which contains Prescription Drug Event records submitted by Medicare Advantage Prescription Drug (MAPD) plans and by stand-alone Prescription Drug Plans (PDP). For each drug, the dataset includes the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost. The total drug cost includes the ingredient cost of the medication, dispensing fees, sales tax, and any applicable administration fees and is based on the amount paid by the Part D plan, Medicare beneficiary, government subsidies, and any other third-party payers.
Tags 2018 summary part d national mpup
API Docs
Created
November 12 2020
Views
700