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.

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.

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.

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.

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.

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.

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. 

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.

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.

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.