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CMS Releases Medicare Provider Utilization and Payment Data for CY 2013

On June 1, 2015, CMS publicly released the “Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File”, which provides information on the services and procedures provided to Medicare beneficiaries by ambulance suppliers, physicians and other healthcare provider groups. The data file is based on calendar year 2013 data. This release follows on last year’s release of payment data for calendar year 2012.

The database lists all individual and organizations providers by National Provider Identifier (NPI), and provides information on utilization, total payments and submitted charges. It can also be searched by Healthcare Common Procedure Coding System (HCPCS) code and place of service.

The Public Use File can be obtained by clicking here: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier.html. Please note that you will need to download the desired file and then import it into an appropriate database or statistical software program. CMS is indicating that Microsoft Excel is not sufficient for these purposes, and that importing it into Excel may result in an incomplete loading of data.

A number of news organizations have already created searchable databases that will allow you to search the 2012 data by physician/organizational name, provider specialty, city, state, etc. It is expected that these news organizations will be updating their websites to incorporate the 2013 data in the coming weeks. The searchable database created by the Wall Street Journal can be accessed by clicking here: http://projects.wsj.com/medicarebilling/?mod=medicarein.

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