About the Data

This section provides information about the data publicly reported on the Medicare.gov compare tool and in the Provider Data Catalog (PDC).

• How often is general and performance information about doctors, clinicians, groups, and Accountable Care Organizations (ACOs) on the Medicare.gov compare tool profile pages and the Provider Data Catalog (PDC) updated?

• What data sources are used for doctor, clinician, and group profile pages on the Medicare.gov compare tool and the Provider Data Catalog (PDC)?

• Is there a downloadable database of all the information currently available on the Medicare.gov compare tool profile pages for doctors, clinicians, and groups?

• What data is currently included in the Provider Data Catalog (PDC)?

• How do I update general information about my group or myself?

• How do I remove personal contact information?

• Is the telehealth indicator on the Medicare.gov compare tool profile pages for doctors, clinicians, and groups?  

• How does the Centers for Medicare & Medicaid Services (CMS) identify telehealth services for the indicator? 

• I provide non-patient-facing or telehealth-based medical care from my home and need to enroll my home as a practice location. How do I prevent my home address and personal phone number from being published on my profile? 

How often is general and performance information about doctors, clinicians, groups, and Accountable Care Organizations (ACOs) on the Medicare.gov compare tool profile pages and the Provider Data Catalog (PDC) updated?

General information for doctors, clinicians, and groups, such as addresses and phone numbers, is updated twice a month. Their performance information is updated on an annual basis. Performance information for Shared Savings Program ACOs is also updated on an annual basis.

What data sources are used for doctor, clinician, and group profile pages on the Medicare.gov compare tool and the Provider Data Catalog (PDC)?

Performance information for doctors, clinicians, and groups comes from the Quality Payment Program (QPP). General information is primarily from the Provider Enrollment, Chain, and Ownership System (PECOS). Some of the information in PECOS, such as group affiliations and practice locations, is verified using claims data. Board certification is derived from certification and accrediting organizations, such as the American Board of Medical Specialties, the American Board of Optometry, and the American Board of Wound Medicine and Surgery. For details about all data files currently used in the PDC, refer to the ­­“Provider Data Catalog: Doctors and Clinicians Data Dictionary.”

Is there a downloadable database of all the information currently available on the Medicare.gov compare tool profile pages for doctors, clinicians, and groups?

The Provider Data Catalog (PDC) is currently available on Data.Medicare.gov and contains general and performance information publicly reported on the Medicare.gov compare tool profile pages for doctors and clinicians. The PDC also includes additional performance information such as final scores and performance category scores, as well as data about facility affiliations and procedures of interest performed by doctors and clinicians.

What data is currently included in the Provider Data Catalog (PDC)?

There are 7 doctors and clinicians downloadable data files currently available in the PDC. The data files include:

• Demographic data describing individual doctors and clinicians;
• Clinician, group, and virtual group Merit-based Incentive Payment System (MIPS) performance information;
• Clinician overall MIPS final score and performance category score information; and
• Clinician utilization (procedure volume) data.

For details about the data files, refer to the ­­“Provider Data Catalog: Doctors and Clinicians Data Dictionary.”

How do I update general information about my group or myself?

Much of the information can be updated in the Provider Enrollment, Chain, and Ownership System (PECOS). Once you update PECOS, the changes will be reflected on profile pages and the Provider Data Catalog (PDC) in 2 to 4 months (the amount of time it takes for the information to be verified and processed).

Individual clinicians can update their first and last name, gender, specialty, education, and group affiliation via PECOS. To update board certification and hospital affiliation, please send an email with your name, National Provider Identifier (NPI), and request to QPP@cms.hhs.gov.  

Groups can update their legal business name, affiliated clinicians, and addresses via PECOS. Groups should email QPP@cms.hhs.gov if they would like to have a “Doing Business As” (DBA) name appear on their profile page.

How do I remove personal contact information?

If your personal information, such as phone numbers or addresses, is displaying on your profile page, send an email to QPP@cms.hhs.gov with the correct contact information so we can make a manual edit to your profile page. The manual edit quickly removes this information from the website; however, the manual edits only remain in effect for 6 months. Therefore, you also need to update this information via the Provider Enrollment, Chain, and Ownership System (PECOS) to ensure your personal information won’t repopulate in the future. We recommend you make the update as soon as possible.

The Centers for Medicare & Medicaid Services (CMS) may suppress street addresses in cases where doctors and clinicians provide non-patient facing or telehealth-only services from their homes, or in instances where there’s a safety concern related to their practice location information being publicly available. Doctors and clinicians can either mark the address as a “Home office for administrative/telehealth use only” location in PECOS, which will suppress street address details, or email the Quality Payment Program (QPP) Service Center to suppress the street address and/or phone number. In such cases, CMS maintains city, state, and zip code information so that doctors and clinicians can still be included in searches and have their performance information reported.

Is the telehealth indicator on the Medicare.gov compare tool profile pages for doctors, clinicians, and groups?  

The telehealth indicator is only on applicable individual doctor and clinician profile pages. Currently, it isn’t operationally feasible to accurately publish telehealth information on group profile pages. For more information, please access the "Telehealth Indicator on Medicare Care Compare: Doctors and Clinicians Public Reporting" fact sheet (PDF, 569 KB).

How does the Centers for Medicare & Medicaid Services (CMS) identify telehealth services for the indicator? 

CMS identifies telehealth services using the most recent Place of Service (POS) and claims modifier codes available and appended on paid physician and ancillary service claims at the time the data are refreshed. CMS uses a 6-month lookback period and refreshes the information on clinician profile pages bi-monthly, as technically feasible. For more information, please access the "Telehealth Indicator on Medicare Care Compare: Doctors and Clinicians Public Reporting" fact sheet (PDF, 569 KB).

I provide non-patient-facing or telehealth-based medical care from my home and need to enroll my home as a practice location. How do I prevent my home address and personal phone number from being published on my profile? 

Doctors and clinicians can either mark the address as a “Home office for administrative/telehealth use only” location in the Provider Enrollment, Chain, and Ownership System (PECOS), which will suppress street address details, or email the Quality Payment Program (QPP) Service Center to suppress the street address and/or phone number.