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The data provided here include estimated hospital-specific charges for 32 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Year (CY) 2014. The Medicare payment amount includes the APC payment amount, the beneficiary Part B coinsurance amount and the beneficiary deductible amount.
Updated
October 31 2017
Views
4,775
CPT copyright 2014 American Medical Association. All Right Reserved. This dataset is subject to the AMA click-agreement. If you have reached this dataset without the click through agreement, please acknowledge your acceptance here: https://data.cms.gov/use-agreement?id=ee7f-sh97
NOTE: This is a very large dataset so some views and actions will take some time to load, particularly in older browsers.
The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Provider Utilization and Payment Data Physician and Other Supplier Public Use File (herein referred to as “Physician and Other Supplier PUF”), with information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The Physician and Other Supplier PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program available from the CMS Chronic Condition Data Warehouse (www.ccwdata.org). The data in the Physician and Other Supplier PUF covers calendar year 2014 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population.
The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Provider Utilization and Payment Data Physician and Other Supplier Public Use File (herein referred to as “Physician and Other Supplier PUF”), with information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The Physician and Other Supplier PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program available from the CMS Chronic Condition Data Warehouse (www.ccwdata.org). The data in the Physician and Other Supplier PUF covers calendar year 2014 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population.
Updated
September 22 2017
Views
65,757
The “Medicare Physician and Other Supplier National Provider Identifier (NPI) Aggregate Report”, a supplement to the Medicare Provider Utilization and Payment Data: Physician and Other Supplier data, contains information on utilization, payments (Medicare allowed amount, Medicare payment, standardized Medicare payment), and submitted charges organized by NPI. Sub-totals for medical type services and drug type services are included as well as overall utilization, payment and charges. In addition, beneficiary demographic and health characteristics are provided which include age, sex, race, Medicare and Medicaid entitlement, chronic conditions and risk scores.
Updated
October 31 2017
Views
30,169
The Home Health Agency Utilization and Payment Public Use File (herein referred to as “Home Health Agency PUF”) presents information on services provided to Medicare beneficiaries by home health agencies. The Home Health Agency PUF contains information on utilization, payment (Medicare payment and standard payment), submitted charges, and demographic and chronic condition indicators organized by CMS Certification Number (6-digit provider identification number), Home Health Resource Group (HHRG), and state of service. This PUF is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Home Health Agency PUF covers calendar year 2014 and contains 100% final-action (i.e., all claim adjustments have been resolved) home health agency institutional claims for the Medicare fee-for-service (FFS) population.
Updated
April 5 2018
Views
782
The Skilled Nursing Facility Utilization and Payment Public Use File (Skilled Nursing Facility PUF) provides information on services provided to Medicare beneficiaries residing in skilled nursing facilities. The Skilled Nursing Facility PUF contains information on utilization, payment (allowed amount, Medicare payment and standard payment), submitted charges and beneficiary demographic and chronic condition indicators organized by CMS Certification Number (6-digit provider identification number), Resource Utilization Group (RUG), and state of service. This PUF is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Skilled Nursing Facility PUF covers calendar year 2014 and contains 100% final-action (i.e., all claim adjustments have been resolved) skilled nursing facility institutional claims for the Medicare fee-for-service (FFS) population.
Updated
October 10 2018
Views
765
CPT copyright 2014 American Medical Association. All Right Reserved. This dataset is subject to the AMA click-agreement. If you have reached this dataset without the click through agreement, please acknowledge your acceptance here: https://data.cms.gov/use-agreement/cpt-code/medicare-provider-data-2014
NOTE: This is a very large dataset so some views and actions will take some time to load, particularly in older browsers.
The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Provider Utilization and Payment Data Physician and Other Supplier Public Use File (herein referred to as “Physician and Other Supplier PUF”), with information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The Physician and Other Supplier PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program available from the CMS Chronic Condition Data Warehouse (www.ccwdata.org). The data in the Physician and Other Supplier PUF covers calendar year 2014 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population.
The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Provider Utilization and Payment Data Physician and Other Supplier Public Use File (herein referred to as “Physician and Other Supplier PUF”), with information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. The Physician and Other Supplier PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program available from the CMS Chronic Condition Data Warehouse (www.ccwdata.org). The data in the Physician and Other Supplier PUF covers calendar year 2014 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population.
Updated
March 8 2017
Views
1,527
The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Home Health Agency Utilization and Payment Public Use File, with information on services provided to Medicare beneficiaries by home health agencies. This table contains information on utilization and payment organized by home health agency and home health resource group (HHRG).
Updated
April 5 2018
Views
363
The Physician/Supplier Procedure Summary (PSPS) file is a summary of calendar year Medicare Part B carrier and durable medical equipment fee-for-service claims. The file is organized by carrier, pricing locality, Healthcare Common Procedure Coding System (HCPCS) code, HCPCS modifier, provider specialty, type of service, and place of service. The summarized fields are total submitted services and charges, total allowed services and charges, total denied services and charges, and total payment amounts. The record layout in the Downloads section below provides additional details on the file.
Updated
July 19 2018
Views
670
The Outpatient Utilization and Payment national summary data presents information on common outpatient services provided to Medicare fee-for-service beneficiaries. The Outpatient PUF presents information on utilization, payment, and estimated hospital-specific charges for 32 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Year (CY) 2014. The Medicare payment amount includes the APC payment amount, the beneficiary Part B coinsurance amount and the beneficiary deductible amount.
Updated
October 31 2017
Views
284
The Skilled Nursing Facility Utilization and Payment Public Use File (Skilled Nursing Facility PUF) provides information on services provided to Medicare beneficiaries residing in skilled nursing facilities. The Skilled Nursing Facility PUF contains information on utilization, payment (allowed amount, Medicare payment and standard payment), submitted charges and beneficiary demographic and chronic condition indicators organized by CMS Certification Number (6-digit provider identification number), Resource Utilization Group (RUG), and state of service. This PUF is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Skilled Nursing Facility PUF covers calendar year 2014 and contains 100% final-action (i.e., all claim adjustments have been resolved) skilled nursing facility institutional claims for the Medicare fee-for-service (FFS) population.
Updated
October 10 2018
Views
245
The Hospice Utilization and Payment Public Use File (Hospice PUF) provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF contains information on utilization, payment (Medicare payment and standard payment), submitted charges, primary diagnoses, sites of service, and hospice beneficiary demographics organized by CMS Certification Number (6-digit provider identification number) and state. This PUF is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Hospice PUF covers calendar year 2014 and contains 100% final-action (i.e., all claim adjustments have been resolved) hospice claims for the Medicare population including beneficiaries enrolled in a Medicare Advantage plan.
Updated
June 27 2018
Views
232
The Outpatient Utilization and Payment state summary data presents information on common outpatient services provided to Medicare fee-for-service beneficiaries. The Outpatient PUF presents information on utilization, payment, and estimated hospital-specific charges for 32 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Year (CY) 2014. The Medicare payment amount includes the APC payment amount, the beneficiary Part B coinsurance amount and the beneficiary deductible amount.
Updated
October 31 2017
Views
210
Assigned beneficiary person-year counts are based on certified ACO Participant Lists for the performance year (PY) associated with the file year (e.g. PY 2014, PY 2015) and based on the assignment methodology and definition of dual eligible beneficiaries in effect for that performance year.
Updated
October 26 2017
Views
660
The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Skilled Nursing Facility Utilization and Payment Public Use File (herein referred to as “Skilled Nursing Facility PUF”), with information on services provided to Medicare beneficiaries residing in skilled nursing facilities. The Skilled Nursing Facility PUF contains information on utilization, payment (allowed amount, Medicare payment and standard payment), and submitted charges organized by CMS Certification Number (6-digit provider identification number), Resource Utilization Group (RUG), and state of service. This PUF is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Skilled Nursing Facility PUF covers calendar year 2014 and contains 100% final-action (i.e., all claim adjustments have been resolved) skilled nursing facility institutional claims for the Medicare fee-for-service (FFS) population.
Although the Skilled Nursing Facility PUF has a wealth of payment and utilization information about skilled nursing facility services, the dataset also has a number of limitations. The information presented in this file does not indicate the quality of care provided by individual skilled nursing facilities. The file only contains cost and utilization information. Additionally, the data are not risk adjusted and thus do not account for differences in the underlying severity of disease of patient populations treated by providers. For additional limitations, please review the methodology document available in the About tab.
Updated
October 10 2018
Views
203
The 2014 Referring Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Public Use File (herein referred to as “Referring Provider DMEPOS PUF”) presents information on DMEPOS products and services provided to Medicare beneficiaries ordered by physicians and other healthcare professionals. The Referring Provider DMEPOS PUF contains data on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code and supplier rental indicator. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program available from the CMS Chronic Condition Data Warehouse (www.ccwdata.org). The data in the Referring Provider DMEPOS PUF covers calendar year 2014 and contains final-action (i.e., all claim adjustments have been resolved) Part B non-institutional DMEPOS line items for the Medicare fee-for-service (FFS) population.
Updated
October 11 2017
Views
168
The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File (PUF), with 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 PUF 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). The dataset identifies providers by their National Provider Identifier (NPI) and the specific prescriptions that were dispensed at their direction, listed by brand name (if applicable) and generic name. For each prescriber 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.
Although the Part D Prescriber PUF has a wealth of information on payment and utilization for Medicare Part D prescriptions, the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physician’s entire practice or all of Medicare as it only includes information on beneficiaries enrolled in the Medicare Part D prescription drug program (i.e., approximately two-thirds of all Medicare beneficiaries). In addition, the data are not intended to indicate the quality of care provided. For additional limitations, please review the methodology document in the About tab.
Updated
November 14 2018
Views
17,201
The Skilled Nursing Facility Utilization and Payment Public Use File (Skilled Nursing Facility PUF) provides information on services provided to Medicare beneficiaries residing in skilled nursing facilities. The Skilled Nursing Facility PUF contains information on utilization, payment (allowed amount, Medicare payment and standard payment), submitted charges and beneficiary demographic and chronic condition indicators organized by CMS Certification Number (6-digit provider identification number), Resource Utilization Group (RUG), and state of service. This PUF is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Skilled Nursing Facility PUF covers calendar year 2014 and contains 100% final-action (i.e., all claim adjustments have been resolved) skilled nursing facility institutional claims for the Medicare fee-for-service (FFS) population.
Updated
October 10 2018
Views
198
The Hospice Utilization and Payment Public Use File (Hospice PUF) provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF contains information on utilization, payment (Medicare payment and standard payment), submitted charges, primary diagnoses, sites of service, and hospice beneficiary demographics organized by CMS Certification Number (6-digit provider identification number) and state. This PUF is based on information from CMS’s Chronic Conditions Data Warehouse (CCW) data files. The data in the Hospice PUF covers calendar year 2014 and contains 100% final-action (i.e., all claim adjustments have been resolved) hospice claims for the Medicare population including beneficiaries enrolled in a Medicare Advantage plan.
Updated
June 27 2018
Views
1,248
The Centers for Medicare & Medicaid Services (CMS) has prepared a public data set, the Medicare Provider Utilization and Payment Data: Part D Prescriber Public Use File (PUF), with 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 PUF 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). The dataset identifies providers by their National Provider Identifier (NPI) and the specific prescriptions that were dispensed at their direction, listed by brand name (if applicable) and generic name. For each prescriber 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.
Although the Part D Prescriber PUF has a wealth of information on payment and utilization for Medicare Part D prescriptions, the dataset has a number of limitations. Of particular importance is the fact that the data may not be representative of a physician’s entire practice or all of Medicare as it only includes information on beneficiaries enrolled in the Medicare Part D prescription drug program (i.e., approximately two-thirds of all Medicare beneficiaries). In addition, the data are not intended to indicate the quality of care provided. For additional limitations, please review the methodology document in the About tab.
Updated
November 14 2018
Views
7,307
Aggregate data consisting of per capita Parts A and B FFS expenditures, average CMS-HCC prospective risk scores and total person-years for assignable beneficiaries by Medicare enrollment type (End Stage Renal Disease (ESRD), disabled, aged/dual eligible, aged/non-dual eligible). It is the intent of CM to publish this PUF annually, in the summer following the conclusion of the calendar year to which it relates.
Updated
August 20 2019
Views
964
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