CMS Data Feeds Catalog

Comprehensive catalog of CMS Data Feeds Dataset tables

Browse available CMS Data Feeds below. Each entry includes description and metadata. Last Updated: 01/21/2025

ACO Realizing Equity, Access and Community Health Aligned Beneficiaries

• Description: The Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) Model Aligned Beneficiary Public Use File (PUF) data details Medicare Beneficiaries aligned to the ACO REACH Model, formerly Global and Professional Direct Contracting (GPDC) Model, including counties, eligibility months and total aligned beneficiaries. This data is redacted and does not include identifiable information.

• Table Name: ACO_Realizing_Equity_Access_and_Community_Health_Aligned_Beneficiaries

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

ACO Realizing Equity, Access and Community Health Eligible Beneficiaries

• Description: Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) Model Eligible Beneficiary Public Use File (PUF) data details Medicare Beneficiaries who were used as the reference population for comparison to aligned to the ACO REACH Model, formerly Global and Professional Direct Contracting (GPDC) Model, including average risk scores and eligibility months. This data is redacted and does not include identifiable information.

• Table Name: ACO_Realizing_Equity_Access_and_Community_Health_Eligible_Beneficiaries

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

ACO Realizing Equity, Access and Community Health Financial and Quality Results

• Description: The Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) Model Financial and Quality Results Public Use File (PUF) details performance for the ACO REACH Model, formerly Global and Professional Direct Contracting (GPDC) Model, prior to settlement. This data includes information such as the ACOs risk arrangement, stop loss, capitation, savings rate, and quality results.

The expanded quality performance results are expected to be released in the fall.

• Table Name: ACO_Realizing_Equity_Access_and_Community_Health_Financial_and_Quality_Results

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

ACO Realizing Equity, Access and Community Health Providers

• Description: The Accountable Care Organization Realizing Equity, Access and Community Health (ACO REACH) Model Providers Public Use File (PUF) data details Participant Providers and Preferred Providers in the ACO REACH Model, formerly Global and Professional Direct Contracting (GPDC) Model. This dataset includes information on each providers capitation arrangement, Advanced Payment Option and elected waivers.

• Table Name: ACO_Realizing_Equity_Access_and_Community_Health_Providers

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

Accountable Care Organization Participants

• Description: The Accountable Care Organization Participants data presents overview information on ACO participants in the Medicare Shared Savings Program (Shared Savings Program), including their name, track status, number of years in the program, and contact information of key personnel.

DISCLAIMER: This information is current as of the last update. 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.

• Table Name: Accountable_Care_Organization_Participants

• Keywords: Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

Accountable Care Organization Skilled Nursing Facility Affiliates

• Description: The Accountable Care Organization Skilled Nursing Facility Affiliates data presents overview information on ACO SNF affiliates in the Medicare Shared Savings Program (Shared Savings Program), including their name, track status, number of years in the program, and contact information of key personnel.

DISCLAIMER: This information is current as of the last update. 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.

• Table Name: Accountable_Care_Organization_Skilled_Nursing_Facility_Affiliates

• Keywords: Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

Accountable Care Organizations

• Description: The Accountable Care Organizations data provides information on ACOs participating in the Medicare Shared Savings Program (Shared Savings Program), including their name, track status, number of years in the program, and contact information for key personnel.

DISCLAIMER: This information is current as of the last update. 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.

• Table Name: Accountable_Care_Organizations

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

Advance Investment Payment Spend Plan

• Description: The Advance Investment Payment Spend Plan data provides payment use, spending category, projected and actual spending of advanced investments payments by Accountable Care Organizations (ACOs).

• Table Name: Advance_Investment_Payment_Spend_Plan

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Financials, Payment Models, Accountable Care Organizations

Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator 11 (PSI-11) Measure Rates

• Description: The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator 11 (PSI-11) Measure Rates dataset provides information on provider-level measure rates regarding one preventable complication (postoperative respiratory failure) for Medicare fee-for-service discharges. The PSI-11 measure data is solely reported for providers’ information and quality improvement purposes and are not a part of the Deficit Reduction Act (DRA) Hospital-Acquired Condition (HAC) Payment Provision or HAC Reduction Program.

• Table Name: Agency_for_Healthcare_Research_and_Quality_AHRQ_Patient_Safety_Indicator__PSI_Measure_Rates

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Inpatient, Health Care Use & Payments, Safety of Care

Ambulatory Surgical Center Quality Measures - Facility

• Description: A list of ambulatory surgical centers participating in the Ambulatory Surgical Center Quality Reporting (ASCQR) Program and their performance rates.

• Table Name: Ambulatory_Surgical_Center_Quality_Measures__Facility

• Keywords: Medicare, Ambulatory Surgical Center Quality Measures - Facility

Ambulatory Surgical Center Quality Measures - National

• Description: This file contains the national averages for all measures reported through the Ambulatory Surgical Center Quality Reporting (ASCQR) Program.

• Table Name: Ambulatory_Surgical_Center_Quality_Measures__National

• Keywords: Medicare, Ambulatory Surgical Center Quality Measures - National

Ambulatory Surgical Center Quality Measures - State

• Description: This file contains state-level data for all measures reported through the Ambulatory Surgical Center Quality Reporting (ASCQR) Program.

• Table Name: Ambulatory_Surgical_Center_Quality_Measures__State

• Keywords: Medicare, Ambulatory Surgical Center Quality Measures - State

Ambulatory Surgical Centers and Independent Free Standing Emergency Departments Enrolled in Medicare As Hospital Providers

• Description: The Ambulatory Surgical Centers (ASCs) and Independent Free Standing Emergency Departments (IFEDs) Enrolled in Medicare As Hospital Providers dataset includes all Medicare enrolled Ambulatory Surgical Centers (ASC) that converted to Hospitals during the COVID-19 public health emergency. Additionally, this list includes Independent Free Standing Emergency Departments (IFEDs) that have been temporarily certified as Hospitals during the COVID-19 public health emergency.

• Table Name: Ambulatory_Surgical_Centers_and_Independent_Free_Standing_Emergency_Departments_Enrolled_in_Medicare_As_Hospital_Providers

• Keywords: States & Territories, ZIP Code, Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Outpatient Facilities, Provider Enrollment

CMS Medicare PSI-90 and component measures - six-digit estimate dataset

• Description: This data set includes the Patient Safety and Adverse Events Composite measure (CMS Medicare PSI 90) and the individual CMS Patient Safety Indicators. CMS Medicare PSI 90 is a composite complication measure composed from 10 separate Patient Safety Indicators. The measure provides an overview of hospital-level quality as it relates to a set of potentially preventable hospital-related events associated with harmful outcomes for patients.

• Table Name: CMS_Medicare_PSI90_and_component_measures__sixdigit_estimate_dataset

• Keywords: Medicare, CMS Medicare PSI-90 and component measures - six-digit estimate dataset

COVID-19 Nursing Home Data

• Description: Submitted data as of the week ending 01/05/2025.

The Nursing Home COVID-19 Public File includes data reported by nursing homes to the CDC’s National Healthcare Safety Network (NHSN) Long Term Care Facility (LTCF) COVID-19 Module. For resources and ways to explore and visualize the data, please see the links to the left, as well as the buttons at the top of the page.

Up to Date with COVID-19 Vaccines

On January 1, 2024, the Centers for Disease Control (CDC) changed the way it collects data to calculate the percent of staff who are up to date with their COVID-19 vaccination. It may take facilities some time to adapt to the new methodology. As a result, the reported percent of staff who are up to date with their COVID-19 vaccination should be viewed with caution over the next few weeks. Contact facilities directly for more information on their vaccination levels.

• Table Name: COVID_Nursing_Home_Data

• Keywords: Medicare, Original Medicare, Medicaid, Hospitals & Facilities, Skilled Nursing, Chronic Conditions, Co-morbidity, COVID-19

CPC Initiative - Participating Primary Care Practices

• Description: The CPC Initiative - Participating Primary Care Practices dataset provides a list of practices involved in a multi-payer initiative which fosters collaboration between public and private health care payers to strengthen primary care.

• Table Name: CPC_Initiative__Participating_Primary_Care_Practices

• Keywords: Medicare, Original Medicare, Value-Based Care, Payment Models

Complications and Deaths - Hospital

• Description: Complications and deaths - provider data. This data set includes provider-level data for the hip/knee complication measure, the CMS Patient Safety Indicators, and 30-day death rates. NOTICE: Data from the 1st and 2nd quarters of 2020 are not being reported due to the impact of the COVID-19 pandemic. For more information, please reference https://qualitynet.cms.gov/files/5fb838aef61c410025a64709?filename=2020-111-IP.pdf.

• Table Name: Complications_and_Deaths__Hospital

• Keywords: Medicare, Complications and Deaths - Hospital

Complications and Deaths - National

• Description: Complications and deaths - national data. This data set includes national-level data for the hip/knee complication measure, the CMS Patient Safety Indicators, and 30-day death rates. NOTICE: Data from the 1st and 2nd quarters of 2020 are not being reported due to the impact of the COVID-19 pandemic. For more information, please reference https://qualitynet.cms.gov/files/5fb838aef61c410025a64709?filename=2020-111-IP.pdf.

• Table Name: Complications_and_Deaths__National

• Keywords: Medicare, Complications and Deaths - National

Complications and Deaths - State

• Description: Complications and deaths - state data. This data set includes state-level data for the hip/knee complication measure, the CMS Patient Safety Indicators, and 30-day death rates. NOTICE: Data from the 1st and 2nd quarters of 2020 are not being reported due to the impact of the COVID-19 pandemic. For more information, please reference https://qualitynet.cms.gov/files/5fb838aef61c410025a64709?filename=2020-111-IP.pdf.

• Table Name: Complications_and_Deaths__State

• Keywords: Medicare, Complications and Deaths - State

Complications and Unplanned Hospital Visits - PPS-Exempt Cancer Hospital - National

• Description: Prospective Payment System (PPS)-Exempt Cancer Hospital Quality Reporting (PCHQR) Complications and Unplanned Hospital Visits. This dataset evaluates the percentage of patients who are receiving PCH-based outpatient chemotherapy treatment for all cancer types except leukemia who were admitted to the hospital or visited the emergency department for one of 10 conditions within 30 days after treatment.

• Table Name: Complications_and_Unplanned_Hospital_Visits__PPSExempt_Cancer_Hospital__National

• Keywords: Medicare, Complications and Unplanned Hospital Visits - PPS-Exempt Cancer Hospital - National

Comprehensive Care For Joint Replacement Model - Provider Data

• Description: Comprehensive Care for Joint Replacement Model - provider data. This data set includes provider data for two quality measures tracked during an episode of care: complication rate for hip/knee replacement patients and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey.

• Table Name: Comprehensive_Care_For_Joint_Replacement_Model__Provider_Data

• Keywords: Medicare, Comprehensive Care For Joint Replacement Model - Provider Data

Comprehensive Care for Joint Replacement Model: Metropolitan Statistical Areas

• Description: The Comprehensive Care for Joint Replacement Model: Metropolitan Statistical Areas (MSAs) dataset presents MSAs that are participating in the CMS Innovation Center Comprehensive Care for Joint Replacement Model, a model to support better and more efficient care for beneficiaries undergoing the most common inpatient surgery for Medicare beneficiaries: hip and knee replacements. Participation in this model is designated by geographic area, specifically MSAs. The information contained in the dataset can include MSA identification number, MSA geographic name and associated county or counties.

• Table Name: Comprehensive_Care_for_Joint_Replacement_Model_Metropolitan_Statistical_Areas

• Keywords: Rural-Urban, Medicare, Original Medicare, Value-Based Care, Payment Models

County-level Aggregate Expenditure and Risk Score Data on Assignable Beneficiaries

• Description: The Shared Savings Program County-level Aggregate Expenditure and Risk Score Data on Assignable Beneficiaries Public Use File (PUF) for the Medicare Shared Savings Program (Shared Savings Program) provides aggregate data consisting of per capita Parts A and B FFS expenditures, average CMS-HCC prospective risk scores, average demographic risk scores and total person-years for Shared Savings Program assignable beneficiaries by Medicare enrollment type (End Stage Renal Disease (ESRD), disabled, aged/dual eligible, aged/non-dual eligible).

DISCLAIMER: This information is current as of the last update. Changes to Shared Savings Program Accountable Care Organization (ACO) information occur periodically. Each Shared Savings Program ACO has the most up-to-date information about their organization. Consider contacting the Shared Savings Program ACO for the latest information. Contact information is available in the ACO PUF and the ACO Participants PUF.

• Table Name: Countylevel_Aggregate_Expenditure_and_Risk_Score_Data_on_Assignable_Beneficiaries

• Keywords: Counties, Medicare, Original Medicare, Value-Based Care, Coordinated Care, Financials, Payment Models, Accountable Care Organizations

Data Updates

• Description: Lists the data updates for a scheduled quarterly refresh and as well those that are updated in between refreshes.

• Table Name: Data_Updates

• Keywords: Medicare, Data Updates

Deficit Reduction Act Hospital-Acquired Condition Measures

• Description: The Publicly Reported Deficit Reduction Act (DRA) Hospital-Acquired Condition (HAC) Measures data provides information on hospital-level measures rates for four of the HACs included in the DRA HAC payment provision – foreign object retained after surgery, blood incompatibility, air embolism, and falls and trauma – for Medicare fee-for-service discharges. The Publicly Reported DRA HAC Measures are reported only for informational and quality improvement purposes; the results of the measure calculations do not affect payment and are not a part of the HAC Reduction Program.

• Table Name: Deficit_Reduction_Act_HospitalAcquired_Condition_Measures

• Keywords: Medicare, Original Medicare, Health Care Use & Payments, Safety of Care

End-Stage Renal Disease Facility Aggregation Group Performance

• Description: The End-Stage Renal Disease (ESRD) Facility Aggregation Group Performance dataset provides performance information in the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. The dataset includes information on Performance Payment Adjustment (PPA), Modality Performance Score (MPS), home dialysis rate, and transplant rate, as well as the individual components of each rate for each model participant ESRD facility aggregation group.

All ESRD facilities within the same aggregation group share the same performance information. The supplementary aggregation group crosswalk file may be used to map aggregation groups to individual ETC Participant ESRD facilities.

• Table Name: EndStage_Renal_Disease_Facility_Aggregation_Group_Performance

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Outpatient Facilities, Clinics, End Stage Renal Disease Facilities, Value-Based Care, Coordinated Care, Service Delivery Models

Facility Affiliation Data

• Description: This is the facility affiliations data publicly reported in the Provider Data Catalog.

• Table Name: Facility_Affiliation_Data

• Keywords: Medicare, Facility Affiliation Data

Facility-Level Minimum Data Set Frequency

• Description: The Facility-Level Minimum Data Set (MDS) Frequency dataset provides information for active nursing home residents on topics, such as race/ethnicity, age, or marital status; discharge dispositions; hearing, speech, and vision; cognitive patterns; mood; functional abilities and goals; bladder and bowel; active diagnoses; health conditions; swallowing/nutritional status; oral/dental status; skin conditions; medications; special treatments, procedures, and programs; restraints and alarms; and participation in assessment and goal setting.

Note: The MDS dataset contains more records than most spreadsheet programs can handle. The use of a database or statistical software is generally required. The dataset can be filtered to a more manageable size for use in a spreadsheet program by clicking on the “View Data” button. Additional filter information can be found in the methodology, if needed.

• Table Name: FacilityLevel_Minimum_Data_Set_Frequency

• Keywords: Medicare, Hospitals & Facilities, Skilled Nursing

Federally Qualified Health Center All Owners

• Description: The Federally Qualified Health Center (FQHC) All Owners dataset provides ownership information on all FQHCs currently enrolled in Medicare. This data includes ownership information such as ownership name, ownership type, ownership address and ownership effective date.

• Table Name: Federally_Qualified_Health_Center_All_Owners

• Keywords: Medicare, Hospitals & Facilities, Outpatient Facilities, Federally Qualified Health Centers, Provider Enrollment

Federally Qualified Health Center Enrollments

• Description: The Federally Qualified Health Center (FQHC) Enrollments dataset provides enrollment information on all FQHCs currently enrolled in Medicare. This data includes information on the FQHC's legal business name, doing business as name, organization type, and address.

• Table Name: Federally_Qualified_Health_Center_Enrollments

• Keywords: Medicare, Hospitals & Facilities, Outpatient Facilities, Federally Qualified Health Centers, Provider Enrollment

Fiscal Intermediary Shared System Attending and Rendering

• Description: The Fiscal Intermediary Shared System (FISS) Attending and Rendering dataset provides a list of those attending and rendering physicians for the FISS. FISS edits require that the Line Item Rendering Physician information be transmitted when providers submit a combined claim. Claims that include both facility and professional components, need to report the rendering physician or other practitioner at the line level if it differs from the rendering physician/practitioner reported at the claim level.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Fiscal_Intermediary_Shared_System_Attending_and_Rendering

• Keywords: Medicare, Original Medicare, Provider Enrollment

Footnote Crosswalk

• Description: The footnote crosswalk displays a list of footnotes and their summary.

• Table Name: Footnote_Crosswalk

• Keywords: Medicare, Footnote Crosswalk

Health Equity - Hospital

• Description: Health Equity measures - provider data. Using social determinants of health data, including race, ethnicity, language, gender identity, sex, sexual orientation, and disability status helps ensure everyone has access to equitable care and coverage.

• Table Name: Health_Equity__Hospital

• Keywords: Medicare, Health Equity - Hospital

Health Equity - National

• Description: Health Equity measures - national data. Using social determinants of health data, including race, ethnicity, language, gender identity, sex, sexual orientation, and disability status helps ensure everyone has access to equitable care and coverage.

• Table Name: Health_Equity__National

• Keywords: Medicare, Health Equity - National

Health Equity - State

• Description: Health Equity measures - state data. Using social determinants of health data, including race, ethnicity, language, gender identity, sex, sexual orientation, and disability status helps ensure everyone has access to equitable care and coverage.

• Table Name: Health_Equity__State

• Keywords: Medicare, Health Equity - State

Healthcare Associated Infections - Hospital

• Description: The Healthcare-Associated Infection (HAI) measures - provider data. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected through the National Healthcare Safety Network (NHSN). They provide information on infections that occur while the patient is in the hospital. These infections can be related to devices, such as central lines and urinary catheters, or spread from patient to patient after contact with an infected person or surface. Many healthcare associated infections can be prevented when the hospitals use CDC-recommended infection control steps.

• Table Name: Healthcare_Associated_Infections__Hospital

• Keywords: Medicare, Healthcare Associated Infections - Hospital

Healthcare Associated Infections - National

• Description: The Healthcare-Associated Infections (HAI) measures - national data. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected through the National Healthcare Safety Network (NHSN). They provide information on infections that occur while the patient is in the hospital. These infections can be related to devices, such as central lines and urinary catheters, or spread from patient to patient after contact with an infected person or surface. Many healthcare associated infections can be prevented when the hospitals use CDC-recommended infection control steps.

• Table Name: Healthcare_Associated_Infections__National

• Keywords: Medicare, Healthcare Associated Infections - National

Healthcare Associated Infections - State

• Description: The Healthcare-Associated Infections (HAI) measures - state data. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected through the National Healthcare Safety Network (NHSN). They provide information on infections that occur while the patient is in the hospital. These infections can be related to devices, such as central lines and urinary catheters, or spread from patient to patient after contact with an infected person or surface. Many healthcare associated infections can be prevented when the hospitals use CDC-recommended infection control steps.

• Table Name: Healthcare_Associated_Infections__State

• Keywords: Medicare, Healthcare Associated Infections - State

Home Health Agency All Owners

• Description: The Home Health Agency (HHA) All Owners dataset provides ownership information on all HHAs currently enrolled in Medicare. This data includes ownership information such as ownership name, ownership type, ownership address and ownership effective date.

• Table Name: Home_Health_Agency_All_Owners

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Home Health, Provider Enrollment

Home Health Agency Cost Report

• Description: The Home Health Agency Provider Cost Report dataset provides select measures from the home health agency annual cost report. This data includes provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data organized by CMS Certification Number.

• Table Name: Home_Health_Agency_Cost_Report

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Home Health, Value-Based Care, Financials

Home Health Agency Enrollments

• Description: The Home Health Agency (HHA) Enrollments dataset provides enrollment information on all HHAs currently enrolled in Medicare. This data includes information on the HHA's legal business name, doing business as name, organization type and address.

• Table Name: Home_Health_Agency_Enrollments

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Home Health, Provider Enrollment

Home Infusion Therapy Providers

• Description: The Home Infusion Therapy Providers dataset provides information on the Providers in Medicare who specialize in Home Infusion Therapy.

• Table Name: Home_Infusion_Therapy_Providers

• Keywords: States & Territories, ZIP Code, Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Outpatient Facilities, Outpatient Physical Therapy, Provider Enrollment

Hospice All Owners

• Description: The Hospice All Owners dataset provides ownership information on all hospices currently enrolled in Medicare. This data includes ownership information such as ownership name, ownership type, ownership address and ownership effective date.

• Table Name: Hospice_All_Owners

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Hospice, Provider Enrollment

Hospice Enrollments

• Description: The Hospice Enrollments dataset provides enrollment information of all hospices currently enrolled in Medicare. This data includes information on the hospice's legal business name, doing business as name, organization type and address.

• Table Name: Hospice_Enrollments

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Hospice, Provider Enrollment

Hospital All Owners

• Description: The Hospital All Owners Information dataset provides information on all owners of the hospitals. This data includes ownership information such as ownership name, ownership type, ownership address and ownership effective date.

• Table Name: Hospital_All_Owners

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Provider Enrollment

Hospital Change of Ownership

• Description: The Hospital Change of Ownership (CHOW) dataset provides information on the hospital ownership changes that occurred on or after January 1, 2016. This data includes information on the buyer and seller organization’s legal business name, provider type, change of ownership type (CHOW, Acquisition/Merger, or Consolidation) and the effective date of the change.

• Table Name: Hospital_Change_of_Ownership

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Provider Enrollment

Hospital Change of Ownership - Owner Information

• Description: The Hospital Change of Ownership (CHOW) - Owner Information dataset provides information on individual and organizational ownership interest and managerial control associated with the buyer and seller organizations, role of the owner, association date, address of the organizational owner and other ownership details.

• Table Name: Hospital_Change_of_Ownership__Owner_Information

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Provider Enrollment

Hospital Enrollments

• Description: The Hospital Enrollments dataset provides enrollment information of all Hospitals currently enrolled in Medicare. This data includes information on the Hospital's sub-group type, legal business name, doing business as name, organization type and address.

• Table Name: Hospital_Enrollments

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Provider Enrollment

Hospital General Information

• Description: A list of all hospitals that have been registered with Medicare. The list includes addresses, phone numbers, hospital type, and overall hospital rating.

• Table Name: Hospital_General_Information

• Keywords: Medicare, Hospital General Information

Hospital Price Transparency Enforcement Activities and Outcomes

• Description: The Hospital Price Transparency Enforcement Activities and Outcomes dataset contains information related to enforcement actions taken by CMS following a compliance review of a hospital's obligation to establish, update and make public a list of the hospital’s standard charges for items and services provided by the hospital, in accordance with regulation (45 CFR 180). This data set includes the name of each hospital or hospital location, the hospital or hospital location address, the outcome or action following a CMS compliance review and the date of the outcome or action taken.

• Table Name: Hospital_Price_Transparency_Enforcement_Activities_and_Outcomes

• Keywords: Medicare, Hospitals & Facilities, Health Care Use & Payments

Hospital Provider Cost Report

• Description: The Hospital Provider Cost Report dataset provides select measures from the hospital annual cost report. This data includes provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data organized by CMS Certification Number.

• Table Name: Hospital_Provider_Cost_Report

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Inpatient, Health Care Use & Payments, Value-Based Care, Financials

Hospital Readmissions Reduction Program

• Description: In October 2012, CMS began reducing Medicare payments for subsection(d) hospitals with excess readmissions under the Hospital Readmissions Reduction Program (HRRP). Excess readmissions are measured by a ratio, calculated by dividing a hospital's predicted rate of readmissions for heart attack (AMI), heart failure (HF), pneumonia, chronic obstructive pulmonary disease (COPD), hip/knee replacement (THA/TKA), and coronary artery bypass graft surgery (CABG) by the expected rate of readmissions, based on an average hospital with similar patients.

• Table Name: Hospital_Readmissions_Reduction_Program

• Keywords: Medicare, Hospital Readmissions Reduction Program

Hospital Service Area

• Description: The Hospital Service Area data is a summary of calendar year Medicare inpatient hospital fee-for-service and Medicare Advantage claims data. It contains number of discharges, total days of care, and total charges summarized by hospital provider number and the ZIP code of the Medicare beneficiary.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Hospital_Service_Area

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Inpatient, Health Care Use & Payments

Hospital Value-Based Purchasing (HVBP) - Clinical Outcomes Domain Scores

• Description: A list of hospitals participating in the FY 2024 Hospital VBP Program and their performance rates and scores for the Clinical Outcomes measures. As finalized in the interim rule with comment period (CMS-3401-IFC), published on September 2, 2020, CMS will not use claims reflecting services provided January 1, 2020-June 30, 2020 (Q1 and Q2 2020) in its calculations for the Medicare quality reporting and value-based purchasing programs. The discharge period has been updated to reflect this policy.

• Table Name: Hospital_ValueBased_Purchasing_HVBP__Clinical_Outcomes_Domain_Scores

• Keywords: Medicare, Hospital Value-Based Purchasing (HVBP) - Clinical Outcomes Domain Scores

Hospital Value-Based Purchasing (HVBP) - Efficiency Scores

• Description: A list of hospitals participating in the FY 2024 Hospital VBP Program and their performance ratios and scores for the Efficiency and Cost Reduction Medicare Spending per Beneficiary (MSPB) measure.

• Table Name: Hospital_ValueBased_Purchasing_HVBP__Efficiency_Scores

• Keywords: Medicare, Hospital Value-Based Purchasing (HVBP) - Efficiency Scores

Hospital Value-Based Purchasing (HVBP) - Person and Community Engagement Domain Scores (HCAHPS)

• Description: A list of hospitals participating in the FY 2024 Hospital VBP Program and their scores for the Person and Community Engagement HCAHPS dimensions.

• Table Name: Hospital_ValueBased_Purchasing_HVBP__Person_and_Community_Engagement_Domain_Scores_HCAHPS

• Keywords: Medicare, Hospital Value-Based Purchasing (HVBP) - Person and Community Engagement Domain Scores (HCAHPS)

Hospital Value-Based Purchasing (HVBP) - Safety

• Description: A list of hospitals participating in the FY 2024 Hospital VBP Program and their performance rates and scores for the Safety measures.

• Table Name: Hospital_ValueBased_Purchasing_HVBP__Safety

• Keywords: Medicare, Hospital Value-Based Purchasing (HVBP) - Safety

Hospital Value-Based Purchasing (HVBP) - Total Performance Score

• Description: A list of hospitals participating in the FY 2024 Hospital VBP Program and their domain scores and Total Performance Scores.

• Table Name: Hospital_ValueBased_Purchasing_HVBP__Total_Performance_Score

• Keywords: Medicare, Hospital Value-Based Purchasing (HVBP) - Total Performance Score

Hospital-Acquired Condition (HAC) Reduction Program

• Description: Hospital-Acquired Condition (HAC) Reduction Program (HACRP) - In October 2014, CMS began reducing Medicare fee-for-service payments for subsection (d) hospitals that rank in the worst-performing quartile with respect to hospital-acquired condition (HAC) quality measures. Hospitals with a Total HAC Score above the 75th percentile of the Total HAC Score distribution will be subject to a 1-percent payment reduction. This table contains hospitals' measure and Total HAC scores. The Total HAC Score is calculated as the equally weighted average of hospitals' individual measure scores.

• Table Name: HospitalAcquired_Condition_HAC_Reduction_Program

• Keywords: Medicare, Hospital-Acquired Condition (HAC) Reduction Program

Innovation Center Data and Reports

• Description: The Innovation Center Data and Reports dataset contains a variety of contributions from CMS Innovation Center models, demonstrations, initiatives and programs. These resources include evaluation reports and associated materials, reports to Congress, and case studies among others.

• Table Name: Innovation_Center_Data_and_Reports

• Keywords: Medicare, Original Medicare, Medicare Advantage, Medicare Prescription Drug, Children's Health Insurance Program, Value-Based Care, Payment Models

Innovation Center Innovation Advisors

• Description: The CMS Innovation Center Innovation Advisors dataset provides information on individuals chosen by CMS as participants in the Innovation Advisors Program. The data includes the name of the initiative, as well as participants names, geographic location including city and state, and geographic reach of the practice.

• Table Name: Innovation_Center_Innovation_Advisors

• Keywords: Medicare, Original Medicare, Medicaid, Value-Based Care, Payment Models

Innovation Center Milestones and Updates

• Description: The Innovation Center Milestones and Updates dataset contains a variety of contributions from CMS Innovation Center models, demonstrations, initiatives and programs. These resources include relevant milestones, dates, and changes to the status or parameters of a model, demonstration, or initiative.

• Table Name: Innovation_Center_Milestones_and_Updates

• Keywords: Medicare, Original Medicare, Medicare Advantage, Medicare Prescription Drug, Children's Health Insurance Program, Value-Based Care, Payment Models

Innovation Center Model Awardees

• Description: The Innovation Center Model Awardees dataset provides information about institutions that have participated in the model process, and have been awarded funding based on their efforts to design, implement, or test innovative healthcare delivery initiatives. The data includes the name of the institution, related keywords, project name, geographic reach, funding amount, real or projected 3-year savings, a summary of the institutions activities in the model, categories related to the type of healthcare initiative, stage of participation, and the URL for the model or initiative page on the CMMI website.

• Table Name: Innovation_Center_Model_Awardees

• Keywords: Medicare, Original Medicare, Value-Based Care, Payment Models

Innovation Center Model Participants

• Description: The Innovation Center Model Participants dataset contains information on current CMS Innovation Center models, demonstrations, initiatives, and programs. This can include the name of the initiative, organization name, location information, address, phase of participation, social media and website URLs, Metropolitan Statistical Area, categories related to health care quality, cost, payment, and delivery, among others. Information on past participants can be found below under resources.

• Table Name: Innovation_Center_Model_Participants

• Keywords: Medicare, Original Medicare, Medicare Advantage, Medicare Prescription Drug, Children's Health Insurance Program, Value-Based Care, Payment Models

Innovation Center Model Summary Information

• Description: The Innovation Center Model Summary Information dataset contains various data points related to CMS Innovation Center models, demonstrations, programs, and initiatives. This can includes name, start and end date, statutory or regulatory authority, keywords, stage of implementation, participants, beneficiaries and physicians impacted, and categories related to health care quality, cost, payment, and delivery.

• Table Name: Innovation_Center_Model_Summary_Information

• Keywords: Medicare, Original Medicare, Medicare Advantage, Medicare Prescription Drug, Children's Health Insurance Program, Value-Based Care, Payment Models

Innovation Center Webinars and Forums

• Description: The Innovation Center Webinars and Forums dataset contains listings of a variety of events from CMS Innovation Center models, demonstrations, initiatives and programs. The types of events include webinars, open door forums, office hours and conference calls among others. These events provide opportunities to learn about current activity, upcoming proceedings and to ask questions and offer feedback.

• Table Name: Innovation_Center_Webinars_and_Forums

• Keywords: Medicare, Original Medicare, Medicare Advantage, Medicare Prescription Drug, Children's Health Insurance Program, Value-Based Care, Payment Models

Inpatient Psychiatric Facility Quality Measure Data - National

• Description: This dataset includes national-level data for quality measures included under the IPFQR program, including HBIPS, SUB, TOB, Transition Record (TR), Screening for Metabolic Disorders (SMD), FAPH, IMM, Readmissions (READM), and Medication Continuation (MedCont, formerly known as MedCoPsy). Psychiatric facilities that are eligible for the Inpatient Psychiatric Facility Quality Reporting (IPFQR) program are required to meet all program requirements, otherwise their Medicare payments may be reduced.

• Table Name: Inpatient_Psychiatric_Facility_Quality_Measure_Data__National

• Keywords: Medicare, Inpatient Psychiatric Facility Quality Measure Data - National

Inpatient Psychiatric Facility Quality Measure Data - by Facility

• Description: This dataset includes provider-level data for quality measures included under the IPFQR program, including HBIPS, SUB, TOB, Transition Record (TR), Screening for Metabolic Disorders (SMD), FAPH, IMM, Readmissions (READM), and Medication Continuation (MedCont, formerly known as MedCoPsy). Psychiatric facilities that are eligible for the Inpatient Psychiatric Facility Quality Reporting (IPFQR) program are required to meet all program requirements, otherwise their Medicare payments may be reduced.

• Table Name: Inpatient_Psychiatric_Facility_Quality_Measure_Data__by_Facility

• Keywords: Medicare, Inpatient Psychiatric Facility Quality Measure Data - by Facility

Inpatient Psychiatric Facility Quality Measure Data - by State

• Description: This dataset includes state-level data for quality measures included under the IPFQR program, including HBIPS, SUB, TOB, Transition Record (TR), Screening for Metabolic Disorders (SMD), FAPH, IMM, Readmissions (READM), and Medication Continuation (MedCont, formerly known as MedCoPsy). Psychiatric facilities that are eligible for the Inpatient Psychiatric Facility Quality Reporting (IPFQR) program are required to meet all program requirements, otherwise their Medicare payments may be reduced.

• Table Name: Inpatient_Psychiatric_Facility_Quality_Measure_Data__by_State

• Keywords: Medicare, Inpatient Psychiatric Facility Quality Measure Data - by State

Long-Term Care Facility Characteristics

• Description: The Long-Term Care Facility Characteristics, CMS Form 671, dataset provides information submitted by nursing homes on the CMS Form 671 collected during annual surveys. The data include information about resident census, ownership, dedicated special care units, facility characteristics, and staffing.

Note: Annual surveys are conducted every 9 to 15 months. Additionally, some states are experiencing delays in conducting annual surveys, resulting in longer periods of time since the last annual survey. As such, some of the data included in these files may not be up to date.

• Table Name: LongTerm_Care_Facility_Characteristics

• Keywords: Medicare, Hospitals & Facilities, Inpatient, Long Term Care, Skilled Nursing

Managing Clinician Aggregation Group Performance

• Description: The Managing Clinician Aggregation Group Performance dataset provides performance information in the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model. The dataset includes information on Performance Payment Adjustment (PPA), Modality Performance Score (MPS), home dialysis rate, and transplant rate, as well as the individual components of each rate for each model participant Managing Clinician aggregation group.

All Managing Clinicians within the same aggregation group share the same performance information. The supplementary aggregation group crosswalk file may be used to map aggregation groups to individual ETC Participant Managing Clinicians.

• Table Name: Managing_Clinician_Aggregation_Group_Performance

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Outpatient Facilities, Clinics, End Stage Renal Disease Facilities, Value-Based Care, Coordinated Care, Service Delivery Models

Market Saturation & Utilization Core-Based Statistical Areas

• Description: The Market Saturation and Utilization Core-Based Statistical Areas (CBSA) dataset provides monitoring of market saturation as a means to help prevent potential fraud, waste, and abuse (FWA). CBSAs are geographical delineations that are Census Bureau-defined urban clusters of at least 10,000 people. Market saturation, in the present context, refers to the density of providers of a particular service within a defined geographic area relative to the number of beneficiaries receiving that service in the area. The data can be used to reveal the degree to which use of a service is related to the number of providers servicing a geographic region. There are also a number of secondary research uses for these data, but one objective of making these data public is to assist health care providers in making informed decisions about their service locations and the beneficiary population they serve.

The interactive dataset can be filtered and analyzed on the site or downloaded in Excel format.

• Table Name: Market_Saturation__Utilization_CoreBased_Statistical_Areas

• Keywords: States & Territories, Rural-Urban, Medicare, Original Medicare, Health Care Use & Payments, Fraud, Waste, & Abuse Prevention

Market Saturation & Utilization State-County

• Description: The Market Saturation and Utilization State-County dataset provides monitoring of market saturation as a means to help prevent potential fraud, waste, and abuse (FWA). Market saturation, in the present context, refers to the density of providers of a particular service within a defined geographic area relative to the number of beneficiaries receiving that service in the area. The data can be used to reveal the degree to which use of a service is related to the number of providers servicing a geographic region. There are also a number of secondary research uses for these data, but one objective of making these data public is to assist health care providers in making informed decisions about their service locations and the beneficiary population they serve.

The interactive dataset can be filtered and analyzed on the site or downloaded in Excel format.

• Table Name: Market_Saturation__Utilization_StateCounty

• Keywords: National, States & Territories, Counties, Medicare, Original Medicare, Health Care Use & Payments, Fraud, Waste, & Abuse Prevention

Maternal Health - Hospital

• Description: These measures are intended to drive improvements in maternal health. By providing care to pregnant individuals that follows best practices that advance health care quality, safety, and equity, hospitals and doctors can improve chances for a safe delivery and a healthy baby.

• Table Name: Maternal_Health__Hospital

• Keywords: Medicare, Maternal Health - Hospital

Maternal Health - National

• Description: These measures are intended to drive improvements in maternal health. By providing care to pregnant individuals that follows best practices that advance health care quality, safety, and equity, hospitals and doctors can improve chances for a safe delivery and a healthy baby.

• Table Name: Maternal_Health__National

• Keywords: Medicare, Maternal Health - National

Maternal Health - State

• Description: These measures are intended to drive improvements in maternal health. By providing care to pregnant individuals that follows best practices that advance health care quality, safety, and equity, hospitals and doctors can improve chances for a safe delivery and a healthy baby.

• Table Name: Maternal_Health__State

• Keywords: Medicare, Maternal Health - State

Measure Dates

• Description: Data Collection Periods for all measures.

• Table Name: Measure_Dates

• Keywords: Medicare, Measure Dates

Medicaid Managed Care

• Description: The Medicaid Managed Care dataset uses CMS' state Transformed Medicaid Statistical Information System (T-MSIS) data for Arizona, Michigan, Nevada, and New Mexico to identify various metrics for managed care plans within each state. These metrics are designed to allow users to compare plans in each state across different specialty areas (currently Pediatric Dental, Behavioral Health, and Prenatal OB/GYN). This dataset does not include all available data in T-MSIS but utilized a subset to calculate the individual metrics identified.

• Table Name: Medicaid_Managed_Care

• Keywords: States & Territories, Counties, Medicaid, Health Care Use & Payments, Health Equity

Medicaid Opioid Prescribing Rates - by Geography

• Description: The Medicaid Opioid Prescribing Rates by Geography dataset provides information on geographic comparisons of the number and percentage of Medicaid opioid prescriptions at the state, county, and ZIP code levels.

• Table Name: Medicaid_Opioid_Prescribing_Rates__by_Geography

• Keywords: National, States & Territories, Medicaid, Physicians & Practitioners, Drugs, Health Equity

Medicaid Spending by Drug

• Description: The Medicaid by Drug dataset presents information on spending for covered outpatient drugs prescribed to beneficiaries enrolled in Medicaid by physicians and other healthcare professionals.

The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. Units refer to the drug unit in the lowest dispensable amount. It also includes spending information for manufacturer(s) of the drugs as well as consumer-friendly information of drug uses and clinical indications.

Drug spending metrics for Medicaid represent the total amount reimbursed by both Medicaid and non-Medicaid entities to pharmacies for the drug. Medicaid drug spending contains both the Federal and State reimbursement and is inclusive of any applicable dispensing fees. In addition, this total is not reduced or affected by Medicaid rebates paid to the states.

• Table Name: Medicaid_Spending_by_Drug

• Keywords: Medicaid, Physicians & Practitioners, Drugs

Medicare Advantage Geographic Variation - National & State

• Description: The Medicare Advantage Geographic Variation National & State dataset provides information on demographic characteristics and service utilization for hospital inpatient, skilled nursing facility services, outpatient, DME, and professional services between 2016-2021 for Medicare Advantage beneficiaries at the national and state levels.

• Table Name: Medicare_Advantage_Geographic_Variation__National__State

• Keywords: National, States & Territories, Medicare, Medicare Advantage, Hospitals & Facilities, Inpatient, Skilled Nursing

Medicare COVID-19 Cases & Hospitalizations

• Description: The Medicare COVID-19 Cases & Hospitalizations data provides COVID-19 cases and hospitalizations data for Medicare beneficiaries diagnosed with COVID-19.

Medicare Claims and Encounter Data for services January 1, 2020 to November 20, 2021, and received by December 17, 2021.

All data are preliminary and will continue to change as more claims and encounters are processed for the reporting period.

• Table Name: Medicare_COVID_Cases__Hospitalizations

• Keywords: States & Territories, Rural-Urban, Medicare, Original Medicare, Chronic Conditions, COVID-19, Health Equity

Medicare COVID-19 Hospitalization Trends

• Description: The Medicare COVID-19 Hospitalization Trends dataset contains aggregate information from Medicare Fee-for-Service claims, Medicare Advantage encounter, and Medicare enrollment data. It provides insight around the groups of beneficiaries that were hospitalized at different points during the pandemic.

CMS publicly released the first Preliminary Medicare COVID-19 Snapshot in June 2020 during the early stages of the Public Health Emergency for COVID-19. That report focused on COVID-19 cases and hospitalizations data for Medicare beneficiaries with a COVID-19 diagnosis. Throughout 2020 and 2021, that report was subsequently updated with refreshed data 13 times. Beginning in October 2021, CMS shifted its public COVID-19 reporting away from cumulative case and hospitalization rates to hospitalization trends over time with the release of this report, the Medicare COVID-19 Hospitalization Trends Report.

All prior releases of both the Preliminary Medicare COVID-19 Snapshot and the Medicare COVID-19 Hospitalization Trends Report are available for download in the Medicare COVID-19 Data - Prior Releases file.

• Table Name: Medicare_COVID_Hospitalization_Trends

• Keywords: States & Territories, Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Inpatient, COVID-19, Health Equity

Medicare Clinical Laboratory Fee Schedule Private Payer Rates and Volumes

• Description: The Medicare Clinical Laboratory Fee Schedule (CLFS) dataset provides raw data reported by any applicable laboratories that reported a volume greater than 10 tests for the data collection period. As described by the Protecting Access to Medicare Act, Applicable Laboratories must report to CMS private payor rates and associated volumes for laboratory tests on the Clinical Laboratory Fee Schedule.

• Table Name: Medicare_Clinical_Laboratory_Fee_Schedule_Private_Payer_Rates_and_Volumes

• Keywords: Medicare, Hospitals & Facilities, Outpatient Facilities, Clinics

Medicare Demonstrations

• Description: The Medicare Demonstrations dataset provides information on demonstrations conducted in the CMS Innovation Center. It includes the demonstration project name, type, description, year, and website for the demonstration page.

• Table Name: Medicare_Demonstrations

• Keywords: Medicare, Original Medicare, Value-Based Care, Payment Models

Medicare Diabetes Prevention Program

• Description: The Medicare Diabetes Prevention Program dataset contains information about suppliers from which eligible Medicare beneficiaries may be furnished associated services. The information in this dataset can include organization name, location, contact information, National Provider Identifier (NPI) among other data points. Location data populates the "Map of MDPP Suppliers furnishing MDPP Services" map.

• Table Name: Medicare_Diabetes_Prevention_Program

• Keywords: Medicare, Original Medicare, Medicare Advantage, Value-Based Care, Payment Models

Medicare Dialysis Facilities

• Description: The Medicare Dialysis Facilities data provides information on clinical and patient measures for Medicare-certified ESRD facilities, also known as dialysis facilities. It contains data on patient characteristics, treatment patterns, hospitalization, mortality, and transplantation patterns in Medicare-certified dialysis facilities.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Medicare_Dialysis_Facilities

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Outpatient Facilities, End Stage Renal Disease Facilities, Chronic Conditions

Medicare Durable Medical Equipment, Devices & Supplies - by Geography and Service

• Description: The Medicare Durable Medical Equipment, Devices & Supplies by Geography and Service dataset contains information on usage, payments, and submitted charges organized by geography, Healthcare Common Procedure Coding System (HCPCS) code, and supplier rental indicator.

• Table Name: Medicare_Durable_Medical_Equipment_Devices__Supplies__by_Geography_and_Service

• Keywords: National, States & Territories, Medicare, Original Medicare, Physicians & Practitioners, Health Care Use & Payments, Health Equity

Medicare Durable Medical Equipment, Devices & Supplies - by Referring Provider

• Description: The Medicare Durable Medical Equipment, Devices & Supplies by Referring Provider dataset contains information on usage, payments, submitted charges and beneficiary demographic and health characteristics organized by National Provider Identifier (NPI).

• Table Name: Medicare_Durable_Medical_Equipment_Devices__Supplies__by_Referring_Provider

• Keywords: Medicare, Original Medicare, Physicians & Practitioners, Medical Suppliers & Equipment, Health Care Use & Payments, Health Equity

Medicare Durable Medical Equipment, Devices & Supplies - by Referring Provider and Service

• Description: The Medicare Durable Medical Equipment, Devices & Supplies by Referring Provider and Service dataset contains information on usage, payments and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and supplier rental indicator.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Medicare_Durable_Medical_Equipment_Devices__Supplies__by_Referring_Provider_and_Service

• Keywords: Medicare, Original Medicare, Physicians & Practitioners, Medical Suppliers & Equipment, Health Care Use & Payments, Health Equity

Medicare Durable Medical Equipment, Devices & Supplies - by Supplier

• Description: The Medicare Durable Medical Equipment, Devices & Supplies by Supplier dataset contains information on usage, payments, submitted charges and beneficiary demographic and health characteristics organized by supplier National Provider Identifier (NPI).

• Table Name: Medicare_Durable_Medical_Equipment_Devices__Supplies__by_Supplier

• Keywords: Medicare, Original Medicare, Physicians & Practitioners, Medical Suppliers & Equipment, Health Care Use & Payments, Health Equity

Medicare Durable Medical Equipment, Devices & Supplies - by Supplier and Service

• Description: The Medicare Durable Medical Equipment, Devices & Supplies by Supplier and Service dataset contains information on usage, payments and submitted charges organized by supplier National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and supplier rental indicator.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Medicare_Durable_Medical_Equipment_Devices__Supplies__by_Supplier_and_Service

• Keywords: Medicare, Original Medicare, Physicians & Practitioners, Medical Suppliers & Equipment, Health Care Use & Payments, Health Equity

Medicare Enrolled Mass Immunizers

• Description: The Medicare Enrolled Mass Immunizers dataset provides information on all Medicare providers that are currently enrolled as Mass Immunizers/Centralized flu billers.

• Table Name: Medicare_Enrolled_Mass_Immunizers

• Keywords: States & Territories, ZIP Code, Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Provider Enrollment

Medicare Fee-For-Service Public Provider Enrollment

• Description: The Medicare Fee-For-Service Public Provider Enrollment dataset includes information on providers who are actively approved to bill Medicare or have completed the 855O at the time the data was pulled from the Provider Enrollment, Chain, and Ownership System (PECOS). The release of this provider enrollment data is not related to other provider information releases such as Physician Compare or Data Transparency.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Medicare_FeeForService__Public_Provider_Enrollment

• Keywords: Medicare, Original Medicare, Provider Enrollment

Medicare Fee-for-Service Comprehensive Error Rate Testing

• Description: The Medicare Fee-for-Service (FFS) Comprehensive Error Rate Testing (CERT) dataset provides information on a random sample of FFS claims to determine if they were paid properly under Medicare coverage, coding, and payment rules. The dataset contains information on type of FFS claim, Diagnosis Related Group (DRG) and Healthcare Common Procedure Coding System (HCPCS) codes, provider type, type of bill, review decision, and error code.

Please note, each reporting year (RY) contains claims submitted July 1 two years before the report through June 30 one year before the report. For example, the 2024 data contains claims submitted July 1, 2022 through June 30, 2023.

• Table Name: Medicare_FeeforService_Comprehensive_Error_Rate_Testing

• Keywords: Medicare, Original Medicare, Health Care Use & Payments

Medicare Geographic Variation - by Hospital Referral Region

• Description: The Medicare Geographic Variation by Hospital Referral Region dataset provides information for researchers and policymakers to evaluate the geographic differences in the use and quality of health care services for the Original Medicare population. The dataset includes demographic, spending, use, and quality indicators at the hospital referral region (HRR) level.

Please note that CMS has decided to discontinue updates to the Fee-for-Service (FFS) Geographic Variation Public Use File by Hospital Referral Region, so the dataset is retired. Data in the FFS Geographic Variation Public Use File by Hospital Referral Region has been divided into two files: 2007-2013 data and 2014-2021 data. This was done to account for changes to the Geographic Variation methodology beginning with data year 2014. The 2007-2013 data is located under data year 2013, and the 2014-2021 data is located under data year 2021.

• Table Name: Medicare_Geographic_Variation__by_Hospital_Referral_Region

• Keywords: National, Hospital Referral Regions, Medicare, Original Medicare, Health Care Use & Payments, Health Equity

Medicare Geographic Variation - by National, State & County

• Description: The Medicare Geographic Variation by National, State & County dataset provides information on the geographic differences in the use and quality of health care services for the Original Medicare population. This dataset contains demographic, spending, use, and quality indicators at the state level (including the District of Columbia, Puerto Rico, and the Virgin Islands) and the county level.

Spending is standardized to remove geographic differences in payment rates for individual services as a source of variation. In general, total standardized per capita costs are less than actual per capita costs because the extra payments Medicare made to hospitals were removed, such as payments for medical education (both direct and indirect) and payments to hospitals that serve a disproportionate share of low-income patients. Standardization does not adjust for differences in beneficiaries’ health status.

• Table Name: Medicare_Geographic_Variation__by_National_State__County

• Keywords: National, States & Territories, Counties, Medicare, Original Medicare, Health Care Use & Payments, Health Equity

Medicare Hospital Spending by Claim

• Description: The data displayed here describes average spending levels during hospitals' Medicare Spending Per Beneficiary (MSPB) episodes by Medicare claim type. The data presented provide price-standardized, non-risk-adjusted values for hospital spending by claim type because risk adjustment is done at the episode level rather than at the service category/claim level. An MSPB episode includes all Medicare Part A and Part B claims paid during the period from 3 days prior to an inpatient hospital admission through 30 days after discharge.

• Table Name: Medicare_Hospital_Spending_by_Claim

• Keywords: Medicare, Medicare Hospital Spending by Claim

Medicare Inpatient Hospitals - by Geography and Service

• Description: The Medicare Inpatient Hospitals by Geography and Service dataset provides information on hospital discharges for Original Medicare Part A beneficiaries by IPPS hospitals. This dataset contains information on the number of discharges, payments, and submitted charges organized by geography and Medicare Severity Diagnosis Related Group (DRG).

• Table Name: Medicare_Inpatient_Hospitals__by_Geography_and_Service

• Keywords: National, States & Territories, Medicare, Original Medicare, Hospitals & Facilities, Inpatient, Health Care Use & Payments, Health Equity

Medicare Inpatient Hospitals - by Provider

• Description: The Medicare Inpatient Hospitals by Provider dataset provides information on inpatient discharges for Original Medicare Part A beneficiaries by IPPS hospitals. It includes information on the use, payment, and hospital charges for more than 3,000 U.S. hospitals that received IPPS payments. The data are organized by hospital.

• Table Name: Medicare_Inpatient_Hospitals__by_Provider

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Inpatient, Health Care Use & Payments, Health Equity

Medicare Inpatient Hospitals - by Provider and Service

• Description: The Medicare Inpatient Hospitals by Provider and Service dataset provides information on inpatient discharges for Original Medicare Part A beneficiaries by IPPS hospitals. It includes information on the use, payment, and hospital charges for more than 3,000 U.S. hospitals that received IPPS payments. The data are organized by hospital and Medicare Severity Diagnosis Related Group (DRG).

Hospitals determine what they will charge for items and services provided to patients, and these charges are the amount the hospital bills for an item or service. The Total Payment Amount includes the DRG amount, claim per diem amount, beneficiary primary payer claim payment amount, beneficiary Part A (Hospital Insurance) coinsurance amount, beneficiary deductible amount, beneficiary blood deductible amount and diagnosis related group outlier amount.

• Table Name: Medicare_Inpatient_Hospitals__by_Provider_and_Service

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Inpatient, Health Care Use & Payments, Health Equity

Medicare Monthly Enrollment

• Description: The Medicare Monthly Enrollment data provides current monthly information on the number of Medicare beneficiaries with hospital/medical coverage and prescription drug coverage, available for several geographic areas including national, state/territory, and county. The hospital/medical coverage data can be broken down further by health care delivery (Original Medicare versus Medicare Advantage and Other Health Plans) and the prescription drug coverage data can be examined by those enrolled in stand-alone Prescription Drug Plans and those enrolled in Medicare Advantage Prescription Drug plans. The dataset provides monthly and yearly enrollee trends.

• Table Name: Medicare_Monthly_Enrollment

• Keywords: National, States & Territories, Counties, Medicare, Original Medicare, Medicare Advantage, Medicare Prescription Drug, Beneficiary Enrollment, Health Equity

Medicare Outpatient Hospitals - by Geography and Service

• Description: The Medicare Outpatient Hospitals by Geography and Service dataset provides information on services for Original Medicare Part B beneficiaries by OPPS hospitals. These datasets contain information on the number of services, payments, and submitted charges organized by geography and comprehensive Ambulatory Payment Classification (APC).

• Table Name: Medicare_Outpatient_Hospitals__by_Geography_and_Service

• Keywords: National, States & Territories, Medicare, Original Medicare, Hospitals & Facilities, Outpatient Facilities, Health Care Use & Payments, Health Equity

Medicare Outpatient Hospitals - by Provider and Service

• Description: The Medicare Outpatient Hospitals by Provider and Service dataset provides information on services for Original Medicare Part B beneficiaries by OPPS hospitals. These datasets contain information on the number of services, payments, and submitted charges organized by provider CMS Certified Number (CCN) and comprehensive Ambulatory Payment Classification (APC).

• Table Name: Medicare_Outpatient_Hospitals__by_Provider_and_Service

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Outpatient Facilities, Health Care Use & Payments, Health Equity

Medicare Part B Discarded Drug Units

• Description: The Medicare Part B Discarded Drug Units dataset provides spending information on claims for Medicare Part B drugs that were identified as having discarded amounts of a drug. As of January 1, 2017, the Centers for Medicare & Medicaid Services (CMS) requires all physicians, hospitals, and other providers submitting claims for Medicare Part B drugs to report any discarded amount of a single use vial or other single use package drug on its claim for payment. With the passage of the Infrastructure Investment and Jobs Act in November 2021, manufacturers must pay a refund to Medicare for discarded amounts above a specified threshold effective for drugs furnished beginning with January 1, 2023.

• Table Name: Medicare_Part_B_Discarded_Drug_Units

• Keywords: Medicare, Original Medicare, Drugs

Medicare Part B Spending by Drug

• Description: The Medicare Part B by Drug dataset presents information on spending for drugs administered in doctors’ offices and other outpatient settings by physicians and other healthcare providers to Medicare Part B enrollees.

The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. It also includes consumer-friendly descriptions of the drug uses, clinical indications, and manufacturer(s).

Drug spending metrics for Part B drugs represent the full value of the product, including the Medicare payment and beneficiary liability. All Part B drug spending metrics are calculated at the HCPCS level.

• Table Name: Medicare_Part_B_Spending_by_Drug

• Keywords: Medicare, Original Medicare, Drugs

Medicare Part D Opioid Prescribing Rates - by Geography

• Description: The Medicare Part D Opioid Prescribing Rates by Geography dataset provides information on geographic comparisons of the number and percentage of Medicare Part D opioid prescriptions at the state, county, and ZIP code levels.

• Table Name: Medicare_Part_D_Opioid_Prescribing_Rates__by_Geography

• Keywords: National, States & Territories, Counties, ZIP Code, Rural-Urban, Medicare, Medicare Prescription Drug, Physicians & Practitioners, Drugs, Health Equity

Medicare Part D Prescribers - by Geography and Drug

• Description: The Medicare Part D Prescribers by Geography and Drug dataset contains information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program. 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.

• Table Name: Medicare_Part_D_Prescribers__by_Geography_and_Drug

• Keywords: National, States & Territories, Medicare, Medicare Prescription Drug, Physicians & Practitioners, Drugs, Health Equity

Medicare Part D Prescribers - by Provider

• Description: The Medicare Part D Prescribers by Provider dataset contains 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 dataset identifies providers by their National Provider Identifier (NPI) and summarizes for each prescriber the total number of prescriptions that were dispensed, which include original prescriptions and any refills, and the total drug cost.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Medicare_Part_D_Prescribers__by_Provider

• Keywords: Medicare, Medicare Prescription Drug, Physicians & Practitioners, Drugs, Health Equity

Medicare Part D Prescribers - by Provider and Drug

• Description: The Medicare Part D Prescribers by Provider and Drug dataset provides information on prescription drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other health care providers. This dataset contains the total number of prescription fills that were dispensed and the total drug cost paid organized by prescribing National Provider Identifier (NPI), drug brand name (if applicable) and drug generic name.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Medicare_Part_D_Prescribers__by_Provider_and_Drug

• Keywords: Medicare, Medicare Prescription Drug, Physicians & Practitioners, Drugs, Health Equity

Medicare Part D Spending by Drug

• Description: The Medicare Part D by Drug dataset presents information on spending for drugs prescribed to Medicare beneficiaries enrolled in Part D by physicians and other healthcare providers. Drugs prescribed in the Medicare Part D program are drugs patients generally administer themselves.

The dataset focuses on average spending per dosage unit and change in average spending per dosage unit over time. It also includes spending information for manufacturer(s) of the drugs as well as consumer-friendly information of drug uses and clinical indications.

Drug spending metrics for Part D drugs are based on the gross drug cost, which represents total spending for the prescription claim, including Medicare, plan, and beneficiary payments. The Part D spending metrics do not reflect any manufacturers’ rebates or other price concessions as CMS is prohibited from publicly disclosing such information.

• Table Name: Medicare_Part_D_Spending_by_Drug

• Keywords: Medicare, Medicare Prescription Drug, Medical Suppliers & Equipment, Drugs

Medicare Physician & Other Practitioners - by Geography and Service

• Description: The Medicare Physician & Other Practitioners by Geography and Service dataset contains information on use, payments, submitted charges, and beneficiary demographic and health characteristics organized by geography, Healthcare Common Procedure Coding System (HCPCS) code, and place of service.

• Table Name: Medicare_Physician__Other_Practitioners__by_Geography_and_Service

• Keywords: National, States & Territories, Medicare, Original Medicare, Physicians & Practitioners, Health Care Use & Payments, Health Equity

Medicare Physician & Other Practitioners - by Provider

• Description: The Medicare Physician & Other Practitioners by Provider dataset provides information on use, payments, submitted charges and beneficiary demographic and health characteristics organized by National Provider Identifier (NPI).

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Medicare_Physician__Other_Practitioners__by_Provider

• Keywords: Medicare, Original Medicare, Physicians & Practitioners, Health Care Use & Payments, Health Equity

Medicare Physician & Other Practitioners - by Provider and Service

• Description: The Medicare Physician & Other Practitioners by Provider and Service dataset provides information on use, payments, and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Medicare_Physician__Other_Practitioners__by_Provider_and_Service

• Keywords: Medicare, Original Medicare, Physicians & Practitioners, Health Care Use & Payments, Health Equity

Medicare Post-Acute Care and Hospice - by Geography & Provider

• Description: The Medicare Post-Acute Care and Hospice Provider Utilization and Payment Public Use Files (PAC PUF) contains information on demographic and clinical characteristics of beneficiaries served, professional and paraprofessional service utilization, and payment information at the provider, state, and national levels for each PAC setting (i.e. HHA, hospices, SNF, IRF, and LTCH). There are additional datasets which can be found as a downloadable report under ‘Resources', which include information specific to the unique variables (e.g., case-mix groups) for HHAs, SNFs and IRFs.

Please note the data included may not be representative of a physician’s entire practice. The data are also not intended to indicate the quality of care provided and are not risk-adjusted to account for differences in underlying severity of disease of patient populations.

More information can be found below in the resources section.

• Table Name: Medicare_PostAcute_Care_and_Hospice__by_Geography__Provider

• Keywords: National, States & Territories, Medicare, Original Medicare, Hospitals & Facilities, Inpatient, Long Term Care, Rehabilitation, Home Health, Hospice, Health Care Use & Payments, Health Equity

Medicare Provider and Supplier Taxonomy Crosswalk

• Description: The Medicare Provider and Supplier Taxonomy Crosswalk dataset lists the providers and suppliers eligible to enroll in Medicare programs with the proper healthcare provider taxonomy code. This data includes the Medicare speciality codes, if available, provider/supplier type description, taxonomy code, and the taxonomy description.

• Table Name: Medicare_Provider_and_Supplier_Taxonomy_Crosswalk

• Keywords: Medicare, Original Medicare, Medicare Advantage, Medical Suppliers & Equipment, Provider Enrollment

Medicare Spending Per Beneficiary - Hospital

• Description: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally. An MSPB episode includes Medicare Part A and Part B payments for services provided by hospitals and other healthcare providers the 3 days prior to, during, and 30 days following a patient's inpatient stay. This measure evaluates hospitals' costs compared to the costs of the national median (or midpoint) hospital. This measure takes into account important factors like patient age and health status (risk adjustment) and geographic payment differences (payment-standardization).

• Table Name: Medicare_Spending_Per_Beneficiary__Hospital

• Keywords: Medicare, Medicare Spending Per Beneficiary - Hospital

Medicare Spending Per Beneficiary - National

• Description: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally. An MSPB episode includes Medicare Part A and Part B payments for services provided by hospitals and other healthcare providers the 3 days prior to, during, and 30 days following a patient's inpatient stay. This measure evaluates hospitals' costs compared to the costs of the national median (or midpoint) hospital. This measure takes into account important factors like patient age and health status (risk adjustment) and geographic payment differences (payment-standardization). The numbers displayed here are: 1) the average MSPB measure for the nation; and 2) the national episode-weighted median MSPB amount used as the denominator in the calculation of each hospital's MSPB measure.

• Table Name: Medicare_Spending_Per_Beneficiary__National

• Keywords: Medicare, Medicare Spending Per Beneficiary - National

Medicare Spending Per Beneficiary - State

• Description: The Medicare Spending Per Beneficiary (MSPB) Measure shows whether Medicare spends more, less, or about the same for an episode of care (episode) at a specific hospital compared to all hospitals nationally. An MSPB episode includes Medicare Part A and Part B payments for services provided by hospitals and other healthcare providers the 3 days prior to, during, and 30 days following a patient's inpatient stay. This measure evaluates hospitals' costs compared to the costs of the national median (or midpoint) hospital. This measure takes into account important factors like patient age and health status (risk adjustment) and geographic payment differences (payment-standardization). The data displayed here are the average measures for each state.

• Table Name: Medicare_Spending_Per_Beneficiary__State

• Keywords: Medicare, Medicare Spending Per Beneficiary - State

Medicare Telehealth Trends

• Description: The Medicare Telehealth Trends dataset provides information about people with Medicare who used telehealth services between January 1, 2020 and June 30, 2024. The data were used to generate the Medicare Telehealth Trends Report.

• Table Name: Medicare_Telehealth_Trends

• Keywords: Medicare

Minimum Data Set Frequency

• Description: The Minimum Data Set (MDS) Frequency data summarizes health status indicators for active residents currently in nursing homes. The MDS is part of the Federally-mandated process for clinical assessment of all residents in Medicare and Medicaid certified nursing homes. This process provides a comprehensive assessment of each resident's functional capabilities and helps nursing home staff identify health problems. Care Area Assessments (CAAs) are part of this process, and provide the foundation upon which a resident's individual care plan is formulated. MDS assessments are completed for all residents in certified nursing homes, regardless of source of payment for the individual resident. MDS assessments are required for residents on admission to the nursing facility, periodically, and on discharge. All assessments are completed within specific guidelines and time frames. In most cases, participants in the assessment process are licensed health care professionals employed by the nursing home. MDS information is transmitted electronically by nursing homes to the national MDS database at CMS.

When reviewing the MDS 3.0 Frequency files, some common software programs e.g., ‘Microsoft Excel’ might inaccurately strip leading zeros from designated code values (i.e., "01" becomes "1") or misinterpret code ranges as dates (i.e., O0600 ranges such as 02-04 are misread as 04-Feb). As each piece of software is unique, if you encounter an issue when reading the CSV file of Frequency data, please open the file in a plain text editor such as ‘Notepad’ or ‘TextPad’ to review the underlying data, before reaching out to CMS for assistance.

• Table Name: Minimum_Data_Set_Frequency

• Keywords: Medicare, Medicaid

Multiple Chronic Conditions

• Description: The Multiple Chronic Conditions dataset provides information on the number of chronic conditions among Original Medicare beneficiaries. The dataset contains prevalence, use and spending organized by geography and the count of chronic conditions from the set of select 21 chronic conditions. The count of conditions is grouped into four categories (0-1, 2-3, 4-5 and 6 or more).

• Table Name: Multiple_Chronic_Conditions

• Keywords: National, States & Territories, Counties, Medicare, Original Medicare, Chronic Conditions, Co-morbidity, Health Care Use & Payments, Health Equity

Number of Accountable Care Organization Assigned Beneficiaries by County

• Description: The Shared Savings Program Number of Accountable Care Organization Assigned Beneficiaries by County dataset provides aggregate data of total assigned beneficiaries by Shared Savings Program ACO for each county where at least one of their assigned beneficiaries resides. Assigned beneficiary person-year counts are based on certified Shared Savings Program ACO Participant Lists and assignment methodology for that performance year.

DISCLAIMER: This information is current as of the last update. Changes to Shared Savings Program ACO information occur periodically. Each Shared Savings Program ACO has the most up-to-date information about their organization. Consider contacting the Shared Savings Program ACO for the latest information. Contact information is available in the ACO Public Use File (PUF) and the ACO Participants PUF.

• Table Name: Number_of_Accountable_Care_Organization_Assigned_Beneficiaries_by_County

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

Nursing Home Affiliated Entity Performance Measures

• Description: The Nursing Home Affiliated Entity Performance Measures dataset provides select quality and performance measures from Care Compare for groups of nursing homes that share common individual or organizational owners, officers, or entities with operational/managerial control. The data include measures such as average health and staffing star ratings, staffing measures, average quality star ratings, select enforcement remedies, claims-based and Minimum Data Set (MDS) measures, average Skilled Nursing Facility Quality Reporting Program (SNF QRP) metrics, and COVID-19 vaccination rates.

• Table Name: Nursing_Home_Affiliated_Entity_Performance_Measures

• Keywords: Medicare, Hospitals & Facilities, Skilled Nursing

Opioid Treatment Program Providers

• Description: The Opioid Treatment Program (OTP) Providers dataset provides information on Providers who have enrolled in Medicare under the Opioid Treatment Program. It contains provider's name, National Provider Identifier (NPI), address, phone number and the effective enrollment date.

• Table Name: Opioid_Treatment_Program_Providers

• Keywords: Medicare, Original Medicare, Drugs, Provider Enrollment

Opt Out Affidavits

• Description: ATTENTION USERS

Some Providers' Opt-Out Status may end early due to COVID 19 waivers. Please contact your respective MAC for further information.

For more information on the opt-out process, see Manage Your Enrollment or view the FAQ section below.

The Opt Out Affidavits dataset provides information on providers who have decided not to participate in Medicare. It contains provider's NPI, specialty, address, and effective dates.

• Table Name: Opt_Out_Affidavits

• Keywords: Medicare, Original Medicare, Medicare Advantage, Provider Enrollment

Order and Referring

• Description: The Order and Referring dataset provides information on all physicians and non-physician practitioners, by their National Provider Identifier (NPI), who are of a type/specialty that is legally eligible to order and refer in the Medicare program and who have current enrollment records in Medicare.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Order_and_Referring

• Keywords: Medicare, Original Medicare, Provider Enrollment

Outpatient Imaging Efficiency - Hospital

• Description: Use of medical imaging - provider data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical imaging tests include CT scans and MRIs.

• Table Name: Outpatient_Imaging_Efficiency__Hospital

• Keywords: Medicare, Outpatient Imaging Efficiency - Hospital

Outpatient Imaging Efficiency - National

• Description: Use of medical imaging - national data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical imaging tests include CT scans and MRIs.

• Table Name: Outpatient_Imaging_Efficiency__National

• Keywords: Medicare, Outpatient Imaging Efficiency - National

Outpatient Imaging Efficiency - State

• Description: Use of medical imaging - state data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical imaging tests include CT scans and MRIs.

• Table Name: Outpatient_Imaging_Efficiency__State

• Keywords: Medicare, Outpatient Imaging Efficiency - State

Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey - Footnotes

• Description: This file contains the footnotes used in the Outpatient and Ambulatory Surgery (OAS CAHPS) survey data. The OAS CAHPS survey collects information about patients' experiences of care in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs).

• Table Name: Outpatient_and_Ambulatory_Surgery_Consumer_Assessment_of_Healthcare_Providers_and_Systems_OAS_CAHPS_survey__Footnotes

• Keywords: Medicare, Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey - Footnotes

Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - Facility

• Description: A list of ambulatory surgical center ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey. The OAS CAHPS survey collects information about patients' experiences of care in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). The data are updated and reported each quarter with data from the most recently completed quarter replacing the oldest quarter of data.

• Table Name: Outpatient_and_Ambulatory_Surgery_Consumer_Assessment_of_Healthcare_Providers_and_Systems_OAS_CAHPS_survey_for_ambulatory_surgical_centers__Facility

• Keywords: Medicare, Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - Facility

Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - National

• Description: The file contains the national average for the OAS CAHPS survey responses. The OAS CAHPS survey collects information about patients' experiences of care in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). The data are updated and reported each quarter with data from the most recently completed quarter replacing the oldest quarter of data.

• Table Name: Outpatient_and_Ambulatory_Surgery_Consumer_Assessment_of_Healthcare_Providers_and_Systems_OAS_CAHPS_survey_for_ambulatory_surgical_centers__National

• Keywords: Medicare, Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - National

Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - State

• Description: A list of the state averages for the OAS CAHPS survey responses. The OAS CAHPS survey collects information about patients' experiences of care in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). The data are updated and reported each quarter with data from the most recently completed quarter replacing the oldest quarter of data.

• Table Name: Outpatient_and_Ambulatory_Surgery_Consumer_Assessment_of_Healthcare_Providers_and_Systems_OAS_CAHPS_survey_for_ambulatory_surgical_centers__State

• Keywords: Medicare, Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - State

Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - Facility

• Description: A list of hospital outpatient department ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey. The OAS CAHPS survey collects information about patients' experiences of care in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). The data are updated and reported each quarter with data from the most recently completed quarter replacing the oldest quarter of data.

• Table Name: Outpatient_and_Ambulatory_Surgery_Consumer_Assessment_of_Healthcare_Providers_and_Systems_OAS_CAHPS_survey_for_hospital_outpatient_departments__Facility

• Keywords: Medicare, Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - Facility

Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - National

• Description: The file contains the national average for the OAS CAHPS survey responses. The OAS CAHPS survey collects information about patients' experiences of care in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). The data are updated and reported each quarter with data from the most recently completed quarter replacing the oldest quarter of data.

• Table Name: Outpatient_and_Ambulatory_Surgery_Consumer_Assessment_of_Healthcare_Providers_and_Systems_OAS_CAHPS_survey_for_hospital_outpatient_departments__National

• Keywords: Medicare, Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - National

Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - State

• Description: A list of the state averages for the OAS CAHPS Survey responses. The OAS CAHPS survey collects information about patients' experiences of care in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs). The data are updated and reported each quarter with data from the most recently completed quarter replacing the oldest quarter of data.

• Table Name: Outpatient_and_Ambulatory_Surgery_Consumer_Assessment_of_Healthcare_Providers_and_Systems_OAS_CAHPS_survey_for_hospital_outpatient_departments__State

• Keywords: Medicare, Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - State

Palliative Care - PPS-Exempt Cancer Hospital - Hospital

• Description: Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. These measures are first steps that seek to broadly assess what is happening in PCHs at the end-of-life and will provide a baseline picture of existing end-of-life care at these hospitals.

• Table Name: Palliative_Care__PPSExempt_Cancer_Hospital__Hospital

• Keywords: Medicare, Palliative Care - PPS-Exempt Cancer Hospital - Hospital

Palliative Care - PPS-Exempt Cancer Hospital - National

• Description: Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. These measures are first steps that seek to broadly assess what is happening in PCHs at the end-of-life and will provide a baseline picture of existing end-of-life care at these hospitals.

• Table Name: Palliative_Care__PPSExempt_Cancer_Hospital__National

• Keywords: Medicare, Palliative Care - PPS-Exempt Cancer Hospital - National

Patient Survey (PCH - HCAHPS) PPS-Exempt Cancer Hospital - Hospital

• Description: A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay.

• Table Name: Patient_Survey_PCH__HCAHPS_PPSExempt_Cancer_Hospital__Hospital

• Keywords: Medicare, Patient Survey (PCH - HCAHPS) PPS-Exempt Cancer Hospital - Hospital

Patient Survey (PCH - HCAHPS) PPS-Exempt Cancer Hospital - National

• Description: The national average for the HCAHPS survey categories. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay.

• Table Name: Patient_Survey_PCH__HCAHPS_PPSExempt_Cancer_Hospital__National

• Keywords: Medicare, Patient Survey (PCH - HCAHPS) PPS-Exempt Cancer Hospital - National

Patient Survey (PCH - HCAHPS) PPS-Exempt Cancer Hospital - State

• Description: A list of the state averages for the HCAHPS survey responses. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay.

• Table Name: Patient_Survey_PCH__HCAHPS_PPSExempt_Cancer_Hospital__State

• Keywords: Medicare, Patient Survey (PCH - HCAHPS) PPS-Exempt Cancer Hospital - State

Patient survey (HCAHPS) - Hospital

• Description: A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay.

• Table Name: Patient_survey_HCAHPS__Hospital

• Keywords: Medicare, Patient survey (HCAHPS) - Hospital

Patient survey (HCAHPS) - National

• Description: The national average for the HCAHPS survey categories. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay.

• Table Name: Patient_survey_HCAHPS__National

• Keywords: Medicare, Patient survey (HCAHPS) - National

Patient survey (HCAHPS) - State

• Description: A list of the state averages for the HCAHPS survey responses. HCAHPS is a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay.

• Table Name: Patient_survey_HCAHPS__State

• Keywords: Medicare, Patient survey (HCAHPS) - State

Patient-Reported Outcomes - Hospital

• Description: Patient-reported outcomes are reports from patients about aspects of care that matter most to them, like pain management, functional ability (like their ability to walk, think, see, hear and remember), and overall quality of life. Through surveys or questionnaires, patients self-report the effectiveness of the care they got from their provider.

• Table Name: PatientReported_Outcomes__Hospital

• Keywords: Medicare, Patient-Reported Outcomes - Hospital

Payment - National

• Description: Payment measures: national data. This data set includes national-level data for the payment measures associated with an episode of care for heart attack, heart failure, pneumonia, and hip/knee replacement patients.

• Table Name: Payment__National

• Keywords: Medicare, Payment - National

Payment - State

• Description: Payment measures: state data. This data set includes state-level data for the payment measures associated with an episode of care for heart attack, heart failure, pneumonia, and hip/knee replacement patients.

• Table Name: Payment__State

• Keywords: Medicare, Payment - State

Payment and value of care - Hospital

• Description: Payment measures and value of care displays: provider data. This data set includes provider data for the payment measures and value of care displays.

• Table Name: Payment_and_value_of_care__Hospital

• Keywords: Medicare, Payment and value of care - Hospital

Payroll Based Journal Daily Non-Nurse Staffing

• Description: The Payroll Based Journal (PBJ) Nurse Staffing and Non-Nurse Staffing datasets provide information submitted by nursing homes including rehabilitation services on a quarterly basis. The data include the hours staff are paid to work each day, for each facility. Examples of reporting categories include Director of Nursing, Administrative Registered Nurses, Registered Nursing, Administrative Licensed Practice Nurses, Licensed Practice Nurses, Certified Nurse Aides, Certified Medication Aides, and Nurse Aides in Training. There are also other non-nurse staff categories provided in the data such as Respiratory Therapist, Occupational Therapist, and Social Worker. The datasets also include a facility’s daily census calculated using the Minimum Data Set (MDS) submission.

The Payroll Based Journal (PBJ) Employee Detail Nursing Home Staffing datasets and technical information have been moved to a new location.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Payroll_Based_Journal_Daily_NonNurse_Staffing

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Skilled Nursing, Health Care Use & Payments

Payroll Based Journal Daily Nurse Staffing

• Description: The Payroll Based Journal (PBJ) Nurse Staffing and Non-Nurse Staffing datasets provide information submitted by nursing homes including rehabilitation services on a quarterly basis. The View Data link above includes the hours staff are paid to work each day, for each facility, aggregated by staff reporting category. Examples of reporting categories include Director of Nursing, Administrative Registered Nurses, Registered Nursing, Administrative Licensed Practice Nurses, Licensed Practice Nurses, Certified Nurse Aides, Certified Medication Aides, and Nurse Aides in Training. There are also other non-nurse staff categories provided in the data such as Respiratory Therapist, Occupational Therapist, and Social Worker. The datasets also include a facility’s daily census calculated using the Minimum Data Set (MDS) submission.

The Payroll Based Journal (PBJ) Employee Detail Nursing Home Staffing datasets and technical information have been moved to a new location.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Payroll_Based_Journal_Daily_Nurse_Staffing

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Skilled Nursing, Health Care Use & Payments

Payroll Based Journal Employee Detail Nursing Home Staffing

• Description: The Payroll Based Journal (PBJ) Employee Detail Nursing Home Staffing dataset provides information submitted by nursing homes including rehabilitation services on a quarterly basis. The data include a system generated employee identification number, work date, job type and employment status, and hours worked for each nursing home employee.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Payroll_Based_Journal_Employee_Detail_Nursing_Home_Staffing

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Skilled Nursing, Health Care Use & Payments

Pending Initial Logging and Tracking Non Physicians

• Description: The Pending Initial Logging and Tracking (L & T) Non Physicians dataset provides a list of pending applications that have not been processed by CMS contractors for Non Physicians.

• Table Name: Pending_Initial_Logging_and_Tracking_Non_Physicians

• Keywords: Medicare, Original Medicare, Medicare Advantage, Provider Enrollment

Pending Initial Logging and Tracking Physicians

• Description: The Pending Initial Logging and Tracking (L & T) Physicians dataset provides a list of pending applications that have not been processed by CMS contractors.

• Table Name: Pending_Initial_Logging_and_Tracking_Physicians

• Keywords: Medicare, Original Medicare, Medicare Advantage, Provider Enrollment

Performance Year Financial and Quality Results

• Description: The Shared Savings Program Performance Year Financial and Quality Results data provides Medicare Shared Savings Program (Shared Savings Program) ACO-specific quality, expenditure, benchmark, and shared savings/loss metrics, as well as summarized beneficiary and provider information for each performance year of the Shared Savings Program.

DISCLAIMER: This information is current as of the last update. Changes to Shared Savings Program ACO information occur periodically. Each Shared Savings Program ACO has the most up-to-date information about their organization. Consider contacting the Shared Savings Program ACO for the latest information. Contact information is available in the ACO Public Use File (PUF) and the ACO Participants PUF.

• Table Name: Performance_Year_Financial_and_Quality_Results

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Financials, Payment Models, Accountable Care Organizations

Physician Fee Schedule National Payment Amount

• Description: The significant size of the Physician Fee Schedule Payment Amount File-National requires that database programs (e.g., Access, dBase, FoxPro, etc.) be used to read these data. Word processing and spreadsheet programs cannot be used. The database programs noted above will also be required to read some versions of the Physician Fee Schedule Payment Amount File Carrier-Specific.

• Table Name: Physician_Fee_Schedule_National_Payment_Amount_File

• Keywords: Medicare, Physician Fee Schedules, National Payment Amount

• Columns:

  • Year: Payment year

  • Carrier: MAC/Carrier code (e.g., "01112")

  • Locality: Locality code within the carrier

  • HCPCS_Code: Procedure or service code

  • Modifier: HCPCS modifier (blank if not used)

  • Non_Facility_Price: Payment amount (non-facility setting)

  • Facility_Price: Payment amount (facility setting)

  • Multiple_Procedure_Indicator: Usually blank or has a value if multiple procedure rules apply

  • Bilateral_Surgery_Indicator: Indicator for bilateral surgery payment rules

  • Status_Code: Payment status (e.g., "A" = Active)

  • Global_Surgery_Indicator: Number of post-op days or "0" for none

  • PE_RVU_Non_Facility: Practice Expense RVU (non-facility)

  • PE_RVU_Facility: Practice Expense RVU (facility)

  • Professional_Technical_Code: "9" if not applicable, otherwise indicator for professional/technical split

  • Malpractice_RVU_Non_Facility: Malpractice RVU (non-facility)

  • Malpractice_RVU_Facility: Malpractice RVU (facility)

Physician/Supplier Procedure Summary

• Description: The Physician/Supplier Procedure Summary (PSPS) data provides a summary of calendar year Medicare Part B carrier and durable medical equipment fee-for-service (FFS) 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. This dataset is produced annually and is typically available in July (i.e., data for CY2015 is usually available in July 2016).

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: PhysicianSupplier_Procedure_Summary

• Keywords: Medicare, Original Medicare, Health Care Use & Payments

Pioneer ACO Model

• Description: The Pioneer Accountable Care Organization (ACO) Model Public Use File (PUF) provides information on ACOs participating in the model. This dataset includes information on each ACO regarding beneficiaries, financial and quality results.

• Table Name: Pioneer_ACO_Model

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

Provider of Services File - Clinical Laboratories

• Description: The Provider of Services (POS) Clinical Laboratories (CLIA) data provides information on CLIA demographics and types of testing services the facility provides. In this file you will find provider number, name, address and characteristics of the participating institution providers.

• Table Name: Provider_of_Services_File__Clinical_Laboratories

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Outpatient Facilities, Clinics, Health Care Use & Payments

Provider of Services File - Hospital & Non-Hospital Facilities

• Description: Please be advised that as of Q4 2023 there is a new Provider of Service file (POS) that contains the provider and certification details for Home Health Agencies (HHAs), Hospices, and Ambulatory Surgical Centers (ASCs). Data contained in this file are extracted from the Internet Quality Improvement and Evaluation System (iQIES) environment and will be updated quarterly along with the other two POS files.

The Provider of Services File - Hospital & Non-Hospital Facilities data provide critical resources for other federal regulator requirements as well as supports the ongoing quality & research efforts sponsored by CMS. In this file you will find provider certification, termination, accreditation, ownership, name, location and other characteristics organized by CMS Certification Number.

• Table Name: Provider_of_Services_File__Hospital__NonHospital_Facilities

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Inpatient, Outpatient Facilities, Provider Enrollment

Provider of Services File - Internet Quality Improvement and Evaluation System - Home Health Agency, Ambulatory Surgical Center, and Hospice Providers

• Description: The Provider of Services File (POS) - Internet Quality Improvement and Evaluation System (iQIES) - Home Health Agency (HHA), Ambulatory Surgical Center (ASC), and Hospice Providers data provides information on provider demographic and associated certification information. In this file you will find provider number (CMS Certification Number), name, address, and other characteristics of the participating institution providers.

• Table Name: Provider_of_Services_File__Internet_Quality_Improvement_and_Evaluation_System__Home_Health_Agency_Ambulatory_Surgical_Center_and_Hospice_Providers

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Home Health, Hospice, Provider Enrollment

Public Reporting of Missing Digital Contact Information

• Description: In the May 2020 CMS Interoperability and Patient Access final rule, CMS finalized the policy to publicly report the names and NPIs of those providers who do not have digital contact information included in the NPPES system (85 FR 25584). This data includes the NPI and provider name of providers and clinicians without digital contact information in NPPES.

• Table Name: Public_Reporting_of_Missing_Digital_Contact_Information

• Keywords: Medicare, Provider Enrollment

Quality Payment Program Experience

• Description: The Quality Payment Program (QPP) Experience dataset provides participation and performance information in the Merit-based Incentive Payment System (MIPS) during each performance year. They cover eligibility and participation, performance categories, and final score and payment adjustments. The dataset provides additional details at the TIN/NPI level on what was published in the previous performance year. You can sort the data by variables like clinician type, practice size, scores, and payment adjustments.

• Table Name: Quality_Payment_Program_Experience

• Keywords: Medicare, Original Medicare, Health Care Use & Payments

Realizing Equity, Access, and Community Health ACOs

• Description: The Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model dataset provides overview information on REACH ACOs including their name, number of years in the program, and contact information of key personnel.

DISCLAIMER: This information is current as of the last update. 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.

• Table Name: Realizing_Equity_Access_and_Community_Health_ACOs

• Keywords: Medicare, Original Medicare, Value-Based Care, Coordinated Care, Payment Models, Accountable Care Organizations

Restructured BETOS Classification System

• Description: The Restructured BETOS Classification System (RBCS) dataset is a taxonomy that allows researchers to group healthcare service codes for Medicare Part B services (i.e., HCPCS codes) into clinically meaningful categories and subcategories. It is based on the original Berenson-Eggers Type of Service (BETOS) classification created in the 1980s, and includes notable updates such as Part B non-physician services. The RBCS will undergo annual updates by a technical expert panel of researchers and clinicians.

• Table Name: Restructured_BETOS_Classification_System

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Outpatient Facilities, Physicians & Practitioners, Medical Suppliers & Equipment

Revalidation Clinic Group Practice Reassignment

• Description: The Revalidation Clinic Group Practice Reassignment dataset provides information between the physician and the group practice they reassign their billing to. It also includes individual employer association counts and the revalidation dates for the individual physician as well as the clinic group practice.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Revalidation_Clinic_Group_Practice_Reassignment

• Keywords: Medicare, Original Medicare, Medicare Advantage, Provider Enrollment

Revalidation Due Date List

• Description: The Revalidation Due Date List dataset contains revalidation due dates for Medicare providers who are due to revalidate in the following six months. If a provider's due date does not fall within the ensuing six months, the due date is marked 'TBD'. In addition the dataset also includes subfiles with reassignment information for a given provider as well as due date listings for clinics and group practices and their providers.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Revalidation_Due_Date_List

• Keywords: Medicare, Original Medicare, Medicare Advantage, Provider Enrollment

Revalidation Reassignment List

• Description: The Revalidation Reassignment List dataset provides information on reassignments of providers who are due for revalidation.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

• Table Name: Revalidation_Reassignment_List

• Keywords: States & Territories, ZIP Code, Medicare, Original Medicare, Medicare Advantage, Provider Enrollment

Rural Health Clinic All Owners

• Description: The Rural Health Clinic (RHC) All Owners dataset provides ownership information on all RHCs currently enrolled in Medicare. This data includes ownership information such as ownership name, ownership type, ownership address and ownership effective date.

• Table Name: Rural_Health_Clinic_All_Owners

• Keywords: Rural-Urban, Medicare, Hospitals & Facilities, Outpatient Facilities, Rural Health Clinics, Provider Enrollment

Rural Health Clinic Enrollments

• Description: The Rural Health Clinic (RHC) Enrollments dataset provides enrollment information on all RHCs currently enrolled in Medicare. This data includes information on the RHC's legal business name, doing business as name, organization type and address.

• Table Name: Rural_Health_Clinic_Enrollments

• Keywords: Rural-Urban, Medicare, Hospitals & Facilities, Outpatient Facilities, Rural Health Clinics, Provider Enrollment

Safety and Healthcare-Associated Infection Measures - PPS-Exempt Cancer Hospital

• Description: Prospective Payment System (PPS)-Exempt Cancer Hospital Quality Reporting (PCHQR) Program Healthcare Associated Infections. These measures are developed by Centers for Disease Control and Prevention (CDC) and collected through the National Healthcare Safety Network (NHSN). They provide information on infections that occur while the patient is in the hospital. These infections can be spread from patient to patient after contact with an infected person or surface. Many healthcare associated infections can be prevented when the hospitals use CDC-recommended infection control steps.

• Table Name: Safety_and_HealthcareAssociated_Infection_Measures__PPSExempt_Cancer_Hospital

• Keywords: Medicare, Safety and Healthcare-Associated Infection Measures - PPS-Exempt Cancer Hospital

Skilled Nursing Facility All Owners

• Description: The Skilled Nursing Facility (SNF) All Owners dataset provides information on all owners of SNFs currently enrolled in Medicare. This data includes ownership information such as ownership name, ownership type, ownership address and ownership effective date.

On November 17, 2023, CMS published in the Federal Register a final rule titled, “Medicare and Medicaid Programs; Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers’ and Suppliers’ Disclosure of Private Equity Companies and Real Estate Investment Trusts” (88 FR 80141). This final rule implements parts of section 1124(c) of the Act which requires SNFs to disclose detailed information about their ownership and management as well as additional data regarding: (1) other parties with which the SNF is associated; and (2) the ownership structures of these other parties. Refer to Medicare Enrollment for Providers & Suppliers for more information on the Skilled Nursing Facility disclosure requirements.

Section 6101(b) of the Affordable Care Act states that no later than 1 year after final regulations promulgated under section 1124(c) of the Act are published in the Federal Register, the Secretary shall make the information reported available to the public.

On November 21, 2024 CMS updated this dataset to include this reported information.

• Table Name: Skilled_Nursing_Facility_All_Owners

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Skilled Nursing, Provider Enrollment

Skilled Nursing Facility Change of Ownership

• Description: The Skilled Nursing Facility (SNF) Change of Ownership (CHOW) dataset provides information on the SNF ownership changes that occurred on or after January 1, 2016. This data includes information on the buyer and seller organization’s legal business name, provider type, change of ownership type (CHOW, Acquisition/Merger, or Consolidation) and the effective date of the change.

• Table Name: Skilled_Nursing_Facility_Change_of_Ownership

• Keywords: Medicare, Original Medicare, Medicare Prescription Drug, Hospitals & Facilities, Provider Enrollment

Skilled Nursing Facility Change of Ownership - Owner Information

• Description: The Skilled Nursing Facility (SNF) Change of Ownership (CHOW) - Owner Information dataset provides information on individual and organizational ownership interest and managerial control associated with the buyer and seller organizations, role of the owner, association date, address of the organizational owner and other ownership details.

• Table Name: Skilled_Nursing_Facility_Change_of_Ownership__Owner_Information

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Provider Enrollment

Skilled Nursing Facility Cost Report

• Description: The Skilled Nursing Facility (SNF) Cost Report dataset is a public use file that provides select measures from the skilled nursing facility annual cost report. This data includes provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data organized by CMS Certification Number.

• Table Name: Skilled_Nursing_Facility_Cost_Report

• Keywords: Medicare, Original Medicare, Hospitals & Facilities, Skilled Nursing, Health Care Use & Payments, Value-Based Care, Financials

Skilled Nursing Facility Enrollments

• Description: The Skilled Nursing Facility (SNF) Enrollments dataset provides enrollment information of all SNF 's currently enrolled in Medicare. This data includes information on the SNF's legal business name, doing business as name, organization type and address.

On November 17, 2023, CMS published in the Federal Register a final rule titled, “Medicare and Medicaid Programs; Disclosures of Ownership and Additional Disclosable Parties Information for Skilled Nursing Facilities and Nursing Facilities; Medicare Providers’ and Suppliers’ Disclosure of Private Equity Companies and Real Estate Investment Trusts” (88 FR 80141). This final rule implements parts of section 1124(c) of the Act which requires SNFs to disclose detailed information about their ownership and management as well as additional data regarding: (1) other parties with which the SNF is associated; and (2) the ownership structures of these other parties. Refer to Medicare Enrollment for Providers & Suppliers for more information on the Skilled Nursing Facility disclosure requirements.

Section 6101(b) of the Affordable Care Act states that no later than 1 year after final regulations promulgated under section 1124(c) of the Act are published in the Federal Register, the Secretary shall make the information reported available to the public.

On November 21, 2024 CMS updated this dataset to include this reported information.

• Table Name: Skilled_Nursing_Facility_Enrollments

• Keywords: Medicare, Original Medicare, Medicare Advantage, Hospitals & Facilities, Skilled Nursing, Provider Enrollment

Specific Chronic Conditions

• Description: The Select Chronic Conditions dataset provides information on 21 selected chronic conditions among Original Medicare beneficiaries. The dataset contains prevalence, use and spending organized by geography and distinct chronic conditions listed below.

• Alcohol Abuse Drug Abuse/ Substance Abuse • Alzheimer’s Disease and Related Dementia • Arthritis (Osteoarthritis and Rheumatoid) • Asthma • Atrial Fibrillation • Autism Spectrum Disorders • Cancer (Breast, Colorectal, Lung, and Prostate) • Chronic Kidney Disease • Chronic Obstructive Pulmonary Disease • Depression • Diabetes • Drug Abuse/ Substance Abuse • Heart Failure • Hepatitis (Chronic Viral B & C) • HIV/AIDS • Hyperlipidemia (High cholesterol) • Hypertension (High blood pressure) • Ischemic Heart Disease • Osteoporosis • Schizophrenia and Other Psychotic Disorders • Stroke

• Table Name: Specific_Chronic_Conditions

• Keywords: National, States & Territories, Counties, Medicare, Original Medicare, Chronic Conditions, Health Care Use & Payments, Health Equity

Strong Start Awardees

• Description: The Strong Start Awardees dataset provides information on the financial awards made to participants in the Strong Start for Mothers and Newborns Initiative. This initiative tested three evidence-based maternity care service approaches with the goal of improving health outcomes of pregnant women and newborns. The data can include the participant name, participant location, locations of practices participating under the participants’ umbrella practice, descriptive text for the type(s) of enhanced prenatal care provided, and the amount of funding awarded to the participant as a result of their participation in year 1 of the initiative.

• Table Name: Strong_Start_Awardees

• Keywords: Medicaid, Children's Health Insurance Program, Health Care Use & Payments, Value-Based Care, Payment Models, Service Delivery Models

Table 1: FY2021 Net Change in Base Operating DRG Payment Amount

• Description: Net Change in Base Operating DRG Payment Amount shows number of hospitals for specified ranges of value-based incentive payment amounts after subtracting the amount by which their Medicare payments per discharge were reduced.

• Table Name: Table_1_FY2021_Net_Change_in_Base_Operating_DRG_Payment_Amount

• Keywords: Medicare, Table 1: FY2021 Net Change in Base Operating DRG Payment Amount

Table 2: FY2021 Distribution of Net Change in Base Operating DRG Payment Amount

• Description: Distribution of Net Change in Base Operating DRG Payment Amount shows the distribution of hospitals' value-based incentive payment amounts after subtracting the amount of the applicable percent reduction from their Medicare payments.

• Table Name: Table_2_FY2021_Distribution_of_Net_Change_in_Base_Operating_DRG_Payment_Amount

• Keywords: Medicare, Table 2: FY2021 Distribution of Net Change in Base Operating DRG Payment Amount

Table 3: FY2021 Percent Change in Medicare Payments

• Description: Percent Change in Medicare Payments displays how hospitals' Medicare payments changed as a result of the Hospital VBP Program in percentage terms.

• Table Name: Table_3_FY2021_Percent_Change_in_Medicare_Payments

• Keywords: Medicare, Table 3: FY2021 Percent Change in Medicare Payments

Table 4: FY2021 Value-Based Incentive Payment Amount

• Description: Value-Based Incentive Payment Amount displays the number of hospitals that received value-based incentive payment amounts in ranges of $50,000.

• Table Name: Table_4_FY2021_ValueBased_Incentive_Payment_Amount

• Keywords: Medicare, Table 4: FY2021 Value-Based Incentive Payment Amount

Timely and Effective Care - Hospital

• Description: Timely and Effective Care measures - provider data. This data set includes provider-level data for measures of cataract surgery outcome, colonoscopy follow-up, emergency department care, preventive care, and pregnancy and delivery care.

• Table Name: Timely_and_Effective_Care__Hospital

• Keywords: Medicare, Timely and Effective Care - Hospital

Timely and Effective Care - National

• Description: Timely and Effective Care measures - national data. This data set includes national-level data for measures of cataract surgery outcome, colonoscopy follow-up, emergency department care, preventive care, and pregnancy and delivery care.

• Table Name: Timely_and_Effective_Care__National

• Keywords: Medicare, Timely and Effective Care - National

Timely and Effective Care - State

• Description: Timely and Effective Care measures - state data. This data set includes state-level data for measures of cataract surgery outcome, colonoscopy follow-up, emergency department care, preventive care, and pregnancy and delivery care.

• Table Name: Timely_and_Effective_Care__State

• Keywords: Medicare, Timely and Effective Care - State

Unplanned Hospital Visits - Hospital

• Description: Unplanned Hospital Visits: provider data. This data set includes provider data for the hospital return days (or excess days in acute care [EDAC]) measures, the unplanned readmissions measures, and measures of unplanned hospital visits after outpatient procedures. NOTICE: Data from the 1st and 2nd quarters of 2020 are not being reported due to the impact of the COVID-19 pandemic. For more information, please reference https://qualitynet.cms.gov/files/5fb838aef61c410025a64709?filename=2020-111-IP.pdf.

• Table Name: Unplanned_Hospital_Visits__Hospital

• Keywords: Medicare, Unplanned Hospital Visits - Hospital

Unplanned Hospital Visits - National

• Description: Unplanned Hospital Visits: national data. This data set includes national-level data for the hospital return days (or excess days in acute care [EDAC]) measures, the unplanned readmissions measures, and measures of unplanned hospital visits after outpatient procedures. NOTICE: Data from the 1st and 2nd quarters of 2020 are not being reported due to the impact of the COVID-19 pandemic. For more information, please reference https://qualitynet.cms.gov/files/5fb838aef61c410025a64709?filename=2020-111-IP.pdf.

• Table Name: Unplanned_Hospital_Visits__National

• Keywords: Medicare, Unplanned Hospital Visits - National

Unplanned Hospital Visits - State

• Description: Unplanned Hospital Visits: state data. This data set includes state-level data for the hospital return days (or excess days in acute care [EDAC]) measures, the unplanned readmissions measures, and measures of unplanned hospital visits after outpatient procedures. NOTICE: Data from the 1st and 2nd quarters of 2020 are not being reported due to the impact of the COVID-19 pandemic. For more information, please reference https://qualitynet.cms.gov/files/5fb838aef61c410025a64709?filename=2020-111-IP.pdf.

• Table Name: Unplanned_Hospital_Visits__State

• Keywords: Medicare, Unplanned Hospital Visits - State

Value Modifier

• Description: The Medicare Value-Based Payment Modifier (Value Modifier) data contains the performance results of de-identified practices that were subject to the Value Modifier, such as the practices' quality and cost tiers along with any applicable Value Modifier payment adjustment. The Value Modifier provided for differential payment under the Medicare Physician Fee Schedule based on the quality of care furnished to Medicare beneficiaries compared to the cost of care during a performance period. Calendar Year 2015 was the first payment adjustment period under the Value Modifier based on performance in 2013. Calendar Year 2018 was the final payment adjustment period under the Value Modifier based on performance in 2016.

The Merit-based Incentive Payment System (MIPS) under the Quality Payment Program has replaced the Value Modifier program. The Centers for Medicare & Medicaid Services (CMS) encourages everyone to learn more about the Quality Payment Program.

• Table Name: Value_Modifier

• Keywords: Medicare, Original Medicare, Value-Based Care, Payment Models

Value of care - National

• Description: Value of care displays: national data. This data set includes national-level data for the value of care displays associated with an episode of care for heart attack, heart failure, pneumonia, and hip/knee replacement patients.

• Table Name: Value_of_care__National

• Keywords: Medicare, Value of care - National

Veterans Health Administration Behavioral Health Data

• Description: A list of VHA hospitals with behavioral health measure data. VHA reports data on a set of core performance measures for Hospital-Based Inpatient Psychiatric Services (HBIPS), Substance Use, and Tobacco Treatment.

• Table Name: Veterans_Health_Administration_Behavioral_Health_Data

• Keywords: Medicare, Veterans Health Administration Behavioral Health Data

Veterans Health Administration Provider Level Data

• Description: A list of all VHA hospitals. The list includes addresses and phone numbers.

• Table Name: Veterans_Health_Administration_Provider_Level_Data

• Keywords: Medicare, Veterans Health Administration Provider Level Data

Veterans Health Administration Timely and Effective Care Data

• Description: A list of VHA hospitals with timely and effective care (process of care) measure data. VHA collects this information through a Quality Improvement Organization (External Peer Review Program) or directly from electronic medical records.

• Table Name: Veterans_Health_Administration_Timely_and_Effective_Care_Data

• Keywords: Medicare, Veterans Health Administration Timely and Effective Care Data