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 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 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.

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 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.

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.

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.

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.