CMS Home Medical Equipment Provider Databank

About the Dataset

The CMS Home Medical Equipment Provider Databank is a comprehensive dataset that provides detailed reimbursement information for over 93,986 unique home medical equipment providers across the United States. This dataset covers an 8-year period from 2015 to the most current CMS release (2022 as of the latest update). It captures approximately $9 billion in total reimbursements for 2022 alone, offering valuable insights into provider performance, reimbursement trends, and market dynamics in the home medical equipment sector.

Dataset Features

• Extensive Historical Data: Covers 7+ years of data from 2015 to 2022, providing a rich historical perspective on home medical equipment (HME) reimbursements.

• Comprehensive Provider Coverage: Includes reimbursement information for more than 62,000 unique home medical equipment providers.

• Broad Industry Representation: With data on 93,986 providers, this dataset offers a comprehensive view of the home medical equipment sector.

• Significant Financial Scope: Tracks approximately $9 billion in reimbursement transactions for 2022, helping users understand the financial landscape of the industry.

• Timely Updates: The dataset is updated within 24 hours of new CMS data releases, which occur annually.

• Flexible Access Options:

  • Trial version: Access to the first 1,000 rows from each year of the dataset.

  • Full subscription: Complete dataset with approximately 550,000 provider records per year.

Data Quality and Maintenance

• Data Source: Centers for Medicare & Medicaid Services (CMS)

• Update Frequency: Annual updates, within 24 hours of new CMS data releases

• Data Cleaning: Provider names are cleaned and standardized to account for variations across states

• Quality Assurance: Regular checks to ensure data accuracy and consistency

Business Applications

• Market analysis and trend identification in the home medical equipment sector

• Competitive benchmarking for HME providers

• Performance tracking and optimization for healthcare providers

• Financial trend analysis for healthcare finance professionals

• Strategic planning for market intelligence professionals

Example Use Cases

1. Market Share Analysis: Identify leading providers and their market share based on total Medicare payments and services rendered.

2. Regional Performance Comparison: Compare provider performance across different states or regions to identify growth opportunities.

3. Product Demand Trends: Analyze the most frequently reimbursed HCPCS codes to understand product demand trends.

4. Reimbursement Rate Analysis: Track changes in reimbursement rates over time for specific HCPCS codes.

5. Provider Efficiency Metrics: Calculate and compare efficiency metrics such as average reimbursement per claim or per beneficiary across providers.

Data Structure

Key columns in the dataset include:

Column Name	Data Type	Description
provider_npi	VARCHAR	(Searchable) National Provider Identifier (NPI) for the supplying provider on the DMEPOS claim.
provider_name	VARCHAR	(Searchable) Provider name or organization, useful for tracking specific entities.
clean_provider_name	VARCHAR	(Searchable) Cleaned and standardized provider names to account for variations across states.
provider_state	VARCHAR	(Searchable) State where the supplier is located, using postal abbreviations.
provider_city	VARCHAR	City where the supplier is located.
provider_zip5	VARCHAR	5-digit ZIP code of the provider's location.
hcpcs_code	VARCHAR	(Searchable) The Healthcare Common Procedure Coding System (HCPCS) code for the specific product or service furnished by the supplier.
hcpcs_description	VARCHAR	A description of the HCPCS code, providing details on the services or products rendered.
total_claims	NUMBER	Total number of DMEPOS claims submitted by the supplier.
total_beneficiaries	NUMBER	Total number of beneficiaries associated with the supplier's services.
total_services	NUMBER	Number of DMEPOS products or services rendered by the supplier.
total_medicare_payments	NUMBER	Total Medicare reimbursement amount for all services provided.
total_medicare_allowed	NUMBER	Total amount allowed by Medicare for all services rendered.

Sample Queries

1. Top 10 providers by total Medicare payments in 2022:

SELECT "Provider NPI", "Clean Provider Name", "Provider State", 
       SUM("Total Medicare Payments") as Total_Payments
FROM cms_hme_provider_databank
WHERE YEAR = 2022
GROUP BY "Provider NPI", "Clean Provider Name", "Provider State"
ORDER BY Total_Payments DESC
LIMIT 10;

1. Average reimbursement per claim by state in 2022:

SELECT "Provider State", 
       AVG("Total Medicare Payments" / NULLIF("Total Claims", 0)) as Avg_Reimbursement_Per_Claim
FROM cms_hme_provider_databank
WHERE YEAR = 2022
GROUP BY "Provider State"
ORDER BY Avg_Reimbursement_Per_Claim DESC;

Support and Contact

For questions, support, or custom data requests related to the CMS Home Medical Equipment Provider Databank, please contact Dataplex Consulting & Data Products at:

• Email: [e-mail]

About Dataplex

Dataplex Consulting & Data Products is a comprehensive data consulting firm that empowers clients with reliable cloud data and analytics solutions. Our team of certified experts in data engineering and analytics offers tailored services to support data-driven enterprises. We provide high-quality data products available on various platforms, including the Snowflake Marketplace, Datarade Marketplace, Databricks Marketplace, Google Analytics Hub, and SAP Datasphere.