The Medicare Telehealth Trends dataset provides information about people with Medicare who used telehealth services between January 1, 2020 and March 31, 2024. The data were used to generate the Medicare Telehealth Trends Report.

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.

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.

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.

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.

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.

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.

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.

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.

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.