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CMS Releases Medicare Part B Payment Data

The Centers for Medicare & Medicaid Services (CMS) released April 9 data on average Medicare Part B payments to more than 880,000 physicians and other health care professionals in calendar year 2012. The data set includes the number and type of services provided to Part B beneficiaries; the average amount Medicare pays for the services, both with and without coinsurance and deductibles; and the provider’s average charge for the service. The data are organized by the National Provider Identifier, Healthcare Common Procedure Coding System code, and the setting in which care was received.

CMS released the data as part of the administration’s effort to increase transparency within the health care system, noting that “the data are not intended to indicate the quality of care provided and are not risk-adjusted to account for differences in underlying severity of disease of patient populations.” CMS urged the public to review the data and assist the agency with addressing Medicare Part B fraud by identifying any outliers.

Please contact Zina Gontscharow, MPP, policy analyst, at zgontscharow@essentialhospitals.org or 202.585.0113 with questions.

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About the Author

Gontscharow is a senior policy analyst for America's Essential Hospitals.