Data

To be transparent, we share extensive data with the public. 

Here are some links to our data sources:

Fast facts

We’ve developed a new quick reference statistical summary of our annual program and financial data:

• Total program enrollment.
• Utilization.
• Expenditures.
• Total number of Medicare providers including physicians by specialty area.

Check back often; this feature’s updated frequently when new data’s available.

Program statistics

Our program statistics include detailed summary statistics on:

• National health care.
• Medicare populations.
• Utilization.
• Expenditures.
• Counts for Medicare-certified institutional and non-institutional providers.

Statistics reference booklet

Our annual Statistics reference booklet gives summary information about:

• Health expenditures.
• Medicare.
• Medicaid.

We publish our Statistics reference booklet each calendar year in June and represents the most currently available information at the time of publication. Statistics reference booklets are available for 2003 through the most current complete calendar year.

Data.Medicare.gov

Data.Medicare.gov lets you download and explore data behind ratings on Medicare.gov.

Data.CMS.gov

Data.CMS.gov lets you interactively analyze our datasets in real-time. All datasets are API-enabled, supporting integration with external websites and applications.

Medicare provider utilization & payment data: Physician & Other Supplier Look-up Tool

The Physician and Other Supplier Look-up Tool is a searchable database that lets you to look up a provider by:

• National Provider Identifier (NPI).
• Name and location.

When you use the look-up tool, you’ll get information on:

• Services and procedures given to Medicare beneficiaries, including utilization information.
• Payment amounts (allowed amount and Medicare payment).
• Submitted charges organized by Healthcare Common Procedure Coding System (HCPCS) code.

The data covers calendar year 2012 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population (information is redacted as needed to protect beneficiary privacy).

Medicare provider utilization & payment data: Inpatient Hospital Public Use File (PUF)

This data includes hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments for the top 100 most frequently billed discharges. These were discharges paid under Medicare based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG) for Fiscal Year (FY) 2011 and 2012.

These DRGs represent more than 7 million discharges or 60 % of total Medicare IPPS discharges.

Hospitals decide what they will charge for items and services given to patients. These charges are the amounts hospitals bill for items or services. The total payment amount includes:

• The MS-DRG amount.
• Bill total per diem.
• Beneficiary primary payer claim payment amount.
• Beneficiary Part A coinsurance amount.
• Beneficiary deductible amount.
• Beneficiary blood deducible amount.
• DRG outlier amount.

Medicare provider utilization & payment data: Outpatient Hospital PUF

The data provided here include estimated hospital-specific charges for 30 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Years (CY) 2011 and 2012. The Medicare payment amount includes:

• APC payment amount.
• Beneficiary Part B coinsurance amount.
• Beneficiary deductible amount.

National Health Expenditures

National Health Expenditures look at:

• Historical annual health spending in the U.S. by type of good or service delivered:
  • Hospital care
  • Physician and clinical services
  • Retail prescription drugs
  • Others
• Source of funding for those services:
  • Private health insurance
  •  Medicare
  • Medicaid
  • Out-of-pocket spending
  • Others

Projections are based on the National Health Expenditures and are estimates of spending for health care in the U.S. over the next decade. Projections are presented by:

• Type of good or service delivered:
  • Hospital care
  • Physician and clinical services
  • Retail prescription drugs
  • Others
• Source of funding for those services:
  • Private health insurance
  • Medicare
  • Medicaid
  • Out-of-pocket spending
  • Others

Provider of Services (POS) file

The POS file has data on characteristics of hospitals and other types of healthcare facilities, including:

• Name and address of the facility.
• Type of Medicare services the facility provides.
• Other information.