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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 medicare improper payment fee-for-service comprehensive error rate testing cert
API Docs
Created
January 21 2021
Views
642

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2019 report period (claims submitted July 1, 2017 through June 30, 2018). These claims were used to calculate the FY 2019 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 fee-for-service medicare cert improper payment comprehensive error rate testing
API Docs
Created
December 30 2019
Views
2,291

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2018 report period (claims submitted July 1, 2016 through June 30, 2017). These claims were used to calculate the FY 2018 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 medicare comprehensive error rate testing cert improper payment fee-for-service
API Docs
Created
January 2 2019
Views
642

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2017 report period (claims submitted July 1, 2015 through June 30, 2016). These claims were used to calculate the FY 2017 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 medicare cert fee-for-service comprehensive error rate testing improper payment
API Docs
Created
March 12 2018
Views
2,180

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2016 report period (claims submitted July 1, 2014 through June 30, 2015). These claims were used to calculate the FY 2016 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 fee-for-service medicare cert improper payment comprehensive error rate testing
API Docs
Created
March 12 2018
Views
483

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2015 report period (claims submitted July 1, 2013 through June 30, 2014). These claims were used to calculate the FY 2015 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 fee-for-service cert comprehensive error rate testing medicare improper payment
API Docs
Created
March 12 2018
Views
396

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2014 report period (claims submitted July 1, 2012 through June 30, 2013). These claims were used to calculate the FY 2014 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 fee-for-service improper payment comprehensive error rate testing medicare cert
API Docs
Created
March 12 2018
Views
350

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2013 report period (claims submitted July 1, 2011 through June 30, 2012). These claims were used to calculate the FY 2013 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 comprehensive error rate testing cert medicare fee-for-service improper payment
API Docs
Created
March 12 2018
Views
266

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2012 report period (claims submitted July 1, 2010 through June 30, 2011). These claims were used to calculate the FY 2012 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 cert improper payment fee-for-service comprehensive error rate testing medicare
API Docs
Created
March 12 2018
Views
277

Medicare - Claims
Dataset
The dataset includes detailed information on Medicare FFS claims that underwent CERT medical review for the FY 2011 report period (claims submitted January 1, 2010 through December 31, 2010). These claims were used to calculate the FY 2011 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 medicare comprehensive error rate testing fee-for-service improper payment cert
API Docs
Created
March 12 2018
Views
340