Medicare Records on 880,000 Health
Care Providers Now Available for Online Download
Gives consumers unprecedented
transparency on the medical services physicians provide and how much
they are paid
April 9, 2014 – There is a lot more
– a whole lot more, actually – information available today to Medicare
beneficiaries who want detailed information on 880,000 distinct health
care providers who received $77 billion in Medicare payments in 2012,
under the Medicare Part B Fee-For-Service program.
Kathleen Sebelius, Health and Human
Services (HHS) Secretary, announced the release of new,
privacy-protected data on services and procedures provided to Medicare
beneficiaries by physicians and other health care professionals. The new
data also show payment and submitted charges, or bills, for those
services and procedures by provider.
“Currently, consumers have limited
information about how physicians and other health care professionals
practice medicine,” said Secretary Sebelius.
The information available is a lot
less limited with this release but the volume is far more than all but a
few senior citizens will be willing to download and wrestle through on
their computer. It is, however, also available to researchers and others
who may want to dig through the mountain of detail.
“This data will help fill that gap
by offering insight into the Medicare portion of a physician’s practice.
The data released today afford researchers, policymakers and the public
a new window into health care spending and physician practice patterns,”
She said this is part of the Obama
administration’s work to make our health care system more transparent,
affordable, and accountable.
The new data set has information
for over 880,000 distinct health care providers who collectively
received $77 billion in Medicare payments in 2012, under the Medicare
Part B Fee-For-Service program.
With this data, it will be possible
to conduct a wide range of analyses that compare 6,000 different types
of services and procedures provided, as well as payments received by
individual health care providers.
information also allows comparisons by -
> the types of medical service and procedures delivered,
> Medicare payment, and
> submitted charges.
Physicians and other health care
professionals determine what they will charge for services and
procedures provided to patients and these “charges” are the amount the
physician or health care professional generally bills for the service or
"Data transparency is a key aspect
of transformation of the health care delivery system,” said CMS
Administrator Marilyn Tavenner. “While there’s more work ahead, this
data release will help beneficiaries and consumers better understand how
care is delivered through the Medicare program.”
Last May, CMS released hospital
charge data allowing consumers to compare what hospitals charge for
common inpatient and outpatient services across the country.
Data are available in two formats:
Tab delimited file format
(requires importing into database or statistical software; SAS® read-in
language is included in the download ZIP package)
Microsoft Excel format
(.xlsx), split by provider last name (note: organizational providers
with name starting with a numeric are available in the “YZ” file).
CMS has also created two summary
1) aggregated information by physician or other supplier and
2) aggregated information by State and HCPCS code. A detailed
methodology document can be found in the Downloads section below which
contains important information regarding the limitations of data usage.
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