Overview of CMS Data
CMS is the federal agency that provides health coverage to more than 160 million individuals through Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplace. CMS collects a variety of data in running these programs. The agency makes certain data products and data files available to external stakeholders as allowed by federal laws, regulations, and CMS policy.
CMS’s data includes information on enrollment and utilization of healthcare services for individuals in Medicare, Medicaid, and the Children’s Health Insurance Program and who sign up for coverage via the Health Insurance Marketplaces as well as quality measures and other provider data.
Data available to Everyone
CMS produces a variety of de-identified public data products including public use files, data tables, dashboards, and mapping tools. These public data products are freely available on CMS’ open data websites.
For more information, see Data Available to Everyone.
Data available to Researchers
CMS makes two types of data products available to researchers as allowed by federal laws, regulations, and CMS policy: limited data set (LDS) files and research identifiable files (RIFs). LDS file and RIF disclosures require a data use agreement (DUA) with CMS and a research study application. In addition, researchers must pay a fee to cover the cost of making the data available.
For more information, see Data Available to Researchers.
Data available to Qualified Entities
The CMS Qualified Entity (QE) Program (also known as the Medicare Data Sharing for Performance Measurement Program) enables organizations to receive Medicare claims data under Parts A, B, and D for use in evaluating provider performance. Organizations approved as QEs are required to use the Medicare data to produce and publicly disseminate CMS-approved reports on provider performance.
For more information, see Data Available to Qualified Entities.
Data available to CMS Contractors
CMS contractors may require access to CMS data to conduct their contracted work. Disclosure of data containing protected health information, personally identifiable information, or other controlled information to CMS contractors requires a data use agreement with CMS.
For more information, see Data Available to CMS Contractors.
Data available to Government Agencies
CMS makes certain data available to other government agencies as allowed by federal laws and regulations as well as CMS policy.
For more information, see Data Available to Government Agencies.