Physician Practice

Increasing amounts of data available on providers

Physician Practice Insider, June 16, 2015

Providers may be surprised at the information that can be easily downloaded about them from the CMS website. On June 1, two fact sheets from CMS announced provider specific data sets available with detailed information on the types of claims and charges submitted to Medicare by hospitals and physicians.
These documents show just a sampling of the information available. CMS maintains a website to provide access to Medicare Provider Utilization and Payment Data. The site contains data on inpatient and outpatient hospital charges as well as physician and non-physician provider data, including both charges and prescribing information.
While the hospital data is detailed, the physician data seems almost invasive. It lists the physician’s name, NPI, credentials, specialty, address, and even gender. Files are available for 2012 and 2013 and contain a line for each HCPCS code billed by the provider more than 10 times during the year. For privacy reasons, lines are not included for HCPCS codes billed 10 or fewer times per year. Information for each HCPCS code includes, among other things, allowed amounts, the provider’s average charges, and Medicare payment amounts.

This excerpted article by Kimberly Anderwood Hoy Baker, JD, originally appeared on HCPro’s
MedicareMentor blog.

Most Popular