The CMS Program Statistics - Medicare Total Enrollment tables provide data on characteristics of the Medicare-covered populations.

For additional information on enrollment, providers, and Medicare use and payment, visit the CMS Program Statistics page.

These data do not exist in a machine-readable format, so the view data and API options are not available. Please use the download function to access the data.

Below is the list of tables:

MDCR ENROLL AB 1. Total Medicare Enrollment: Total, Original Medicare, and Medicare Advantage and Other Health Plan Enrollment, Yearly Trend MDCR ENROLL AB 2. Total Medicare Enrollment: Total, Original Medicare, Medicare Advantage and Other Health Plan Enrollment, and Resident Population, by Area of Residence MDCR ENROLL AB 3. Total Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, Yearly Trend MDCR ENROLL AB 4. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Age Group, Yearly Trend MDCR ENROLL AB 5. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Demographic Characteristics MDCR ENROLL AB 6. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Demographic Characteristics MDCR ENROLL AB 7. Total Medicare Enrollment: Part A and/or Part B Total, Aged, and Disabled Enrollees, by Area of Residence MDCR ENROLL AB 8. Total Medicare Enrollment: Part A and/or Part B Enrollees, by Type of Entitlement and Area of Residence

The Medicare Telehealth Trends dataset provides information about people with Medicare who used telehealth services between January 1, 2020 and June 30, 2024. The data were used to generate the Medicare Telehealth Trends Report.

Context

The CMS National Plan and Provider Enumeration System (NPPES) was developed as part of the Administrative Simplification provisions in the original HIPAA act. The primary purpose of NPPES was to develop a unique identifier for each physician that billed medicare and medicaid. This identifier is now known as the National Provider Identifier Standard (NPI) which is a required 10 digit number that is unique to an individual provider at the national level.

Once an NPI record is assigned to a healthcare provider, parts of the NPI record that have public relevance, including the provider’s name, speciality, and practice address are published in a searchable website as well as downloadable file of zipped data containing all of the FOIA disclosable health care provider data in NPPES and a separate PDF file of code values which documents and lists the descriptions for all of the codes found in the data file.

Content

The dataset contains the latest NPI downloadable file in an easy to query BigQuery table, npi_raw. In addition, there is a second table, npi_optimized which harnesses the power of Big Query’s next-generation columnar storage format to provide an analytical view of the NPI data containing description fields for the codes based on the mappings in Data Dissemination Public File - Code Values documentation as well as external lookups to the healthcare provider taxonomy codes . While this generates hundreds of columns, BigQuery makes it possible to process all this data effectively and have a convenient single lookup table for all provider information.

Fork this kernel to get started.

Acknowledgements

https://bigquery.cloud.google.com/dataset/bigquery-public-data:nppes?_ga=2.117120578.-577194880.1523455401

https://console.cloud.google.com/marketplace/details/hhs/nppes?filter=category:science-research

Dataset Source: Center for Medicare and Medicaid Services. This dataset is publicly available for anyone to use under the following terms provided by the Dataset Source - http://www.data.gov/privacy-policy#data_policy — and is provided "AS IS" without any warranty, express or implied, from Google. Google disclaims all liability for any damages, direct or indirect, resulting from the use of the dataset.

Banner Photo by @rawpixel from Unplash.

Inspiration

What are the top ten most common types of physicians in Mountain View?

What are the names and phone numbers of dentists in California who studied public health?

Context

This public dataset was created by the Centers for Medicare & Medicaid Services. The data summarize counts of enrollees who are dually-eligible for both Medicare and Medicaid program, including those in Medicare Savings Programs. “Duals” represent 20 percent of all Medicare beneficiaries, yet they account for 34 percent of all spending by the program, according to the Commonwealth Fund . As a representation of this high-needs, high-cost population, these data offer a view of regions ripe for more intensive care coordination that can address complex social and clinical needs. In addition to the high cost savings opportunity to deliver upstream clinical interventions, this population represents the county-by-county volume of patients who are eligible for both state level (Medicaid) and federal level (Medicare) reimbursements and potential funding streams to address unmet social needs across various programs, waivers, and other projects. The dataset includes eligibility type and enrollment by quarter, at both the state and county level. These data represent monthly snapshots submitted by states to the CMS, which are inherently lower than ever-enrolled counts (which include persons enrolled at any time during a calendar year.) For more information on dually eligible beneficiaries

Querying BigQuery tables

You can use the BigQuery Python client library to query tables in this dataset in Kernels. Note that methods available in Kernels are limited to querying data. Tables are at bigquery-public-data.sdoh_cms_dual_eligible_enrollment.

Sample Query

In what counties in Michigan has the number of dual-eligible individuals increased the most from 2015 to 2018? Find the counties in Michigan which have experienced the largest increase of dual enrollment households

duals_Jan_2015 AS ( SELECT Public_Total AS duals_2015, County_Name, FIPS FROM bigquery-public-data.sdoh_cms_dual_eligible_enrollment.dual_eligible_enrollment_by_county_and_program WHERE State_Abbr = "MI" AND Date = '2015-12-01' ),

duals_increase AS ( SELECT d18.FIPS, d18.County_Name, d15.duals_2015, d18.duals_2018, (d18.duals_2018 - d15.duals_2015) AS total_duals_diff FROM duals_Jan_2018 d18 JOIN duals_Jan_2015 d15 ON d18.FIPS = d15.FIPS )

SELECT * FROM duals_increase WHERE total_duals_diff IS NOT NULL ORDER BY total_duals_diff DESC

NCHS has linked data from various surveys with Medicare program enrollment and health care utilization and expenditure data from the Centers for Medicare & Medicaid Services (CMS). Linkage of the NCHS survey participants with the CMS Medicare data provides the opportunity to study changes in health status, health care utilization and costs, and prescription drug use among Medicare enrollees. Medicare is the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.

The All CMS Data Feeds dataset is an expansive resource offering access to 119 unique report feeds, providing in-depth insights into various aspects of the U.S. healthcare system including nursing facility owners and accountable care organization participants contact data. With over 25.8 billion rows of data meticulously collected since 2007, this dataset is invaluable for healthcare professionals, analysts, researchers, and businesses seeking to understand and analyze healthcare trends, performance metrics, and demographic shifts over time. The dataset is updated monthly, ensuring that users always have access to the most current and relevant data available.

Dataset Overview:

118 Report Feeds: - The dataset includes a wide array of report feeds, each providing unique insights into different dimensions of healthcare. These topics range from Medicare and Medicaid service metrics, patient demographics, provider information, financial data, and much more. The breadth of information ensures that users can find relevant data for nearly any healthcare-related analysis. - As CMS releases new report feeds, they are automatically added to this dataset, keeping it current and expanding its utility for users.

25.8 Billion Rows of Data:

• With over 25.8 billion rows of data, this dataset provides a comprehensive view of the U.S. healthcare system. This extensive volume of data allows for granular analysis, enabling users to uncover insights that might be missed in smaller datasets. The data is also meticulously cleaned and aligned, ensuring accuracy and ease of use.

Historical Data Since 2007: - The dataset spans from 2007 to the present, offering a rich historical perspective that is essential for tracking long-term trends and changes in healthcare delivery, policy impacts, and patient outcomes. This historical data is particularly valuable for conducting longitudinal studies and evaluating the effects of various healthcare interventions over time.

Monthly Updates:

• To ensure that users have access to the most current information, the dataset is updated monthly. These updates include new reports as well as revisions to existing data, making the dataset a continuously evolving resource that stays relevant and accurate.

Data Sourced from CMS:

• The data in this dataset is sourced directly from the Centers for Medicare & Medicaid Services (CMS). After collection, the data is meticulously cleaned and its attributes are aligned, ensuring consistency, accuracy, and ease of use for any application. Furthermore, any new updates or releases from CMS are automatically integrated into the dataset, keeping it comprehensive and current.

Use Cases:

Market Analysis:

• The dataset is ideal for market analysts who need to understand the dynamics of the healthcare industry. The extensive historical data allows for detailed segmentation and analysis, helping users identify trends, market shifts, and growth opportunities. The comprehensive nature of the data enables users to perform in-depth analyses of specific market segments, making it a valuable tool for strategic decision-making.

Healthcare Research:

• Researchers will find the All CMS Data Feeds dataset to be a robust foundation for academic and commercial research. The historical data, combined with the breadth of coverage across various healthcare metrics, supports rigorous, in-depth analysis. Researchers can explore the effects of healthcare policies, study patient outcomes, analyze provider performance, and more, all within a single, comprehensive dataset.

Performance Tracking:

• Healthcare providers and organizations can use the dataset to track performance metrics over time. By comparing data across different periods, organizations can identify areas for improvement, monitor the effectiveness of initiatives, and ensure compliance with regulatory standards. The dataset provides the detailed, reliable data needed to track and analyze key performance indicators.

Compliance and Regulatory Reporting:

• The dataset is also an essential tool for compliance officers and those involved in regulatory reporting. With detailed data on provider performance, patient outcomes, and healthcare utilization, the dataset helps organizations meet regulatory requirements, prepare for audits, and ensure adherence to best practices. The accuracy and comprehensiveness of the data make it a trusted resource for regulatory compliance.

Data Quality and Reliability:

The All CMS Data Feeds dataset is designed with a strong emphasis on data quality and reliability. Each row of data is meticulously cleaned and aligned, ensuring that it is both accurate and consistent. This attention to detail makes the dataset a trusted resource for high-stakes applications, where data quality is critical.

Integration and Usability:

Ease of Integration:

• The dataset is provided in a CSV format, which is widely compatible with most data analysis too...

Content

This crosswalk links the types of providers and suppliers who are eligible to apply for enrollment in the Medicare program with the appropriate Healthcare Provider Taxonomy Codes. This crosswalk includes the Medicare Specialty Codes for those provider/supplier types who have Medicare Specialty Codes. The Healthcare Provider Taxonomy Code Set is available from the Washington Publishing Company (www.wpc-edi.com) and is maintained by the National Uniform Claim Committee (www.nucc.org). The code set is updated twice a year, with the updates being effective April 1 and October 1 of each year. This document reflects Healthcare Provider Taxonomy Codes effective for use on April 2, 2018.

When changes are made to Medicare provider enrollment requirements, the Medicare Specialty Codes, or the Healthcare Provider Taxonomy Code Set, this document may need to be revised.

NOTE: This document does not alter existing Medicare claims preparation, processing, or payment instructions, nor does it alter existing Medicare provider enrollment requirements or policies.

Context

This is a dataset hosted by the Centers for Medicare & Medicaid Services (CMS). The organization has an open data platform found here and they update their information according the amount of data that is brought in. Explore CMS's Data using Kaggle and all of the data sources available through the CMS organization page!

• Update Frequency: This dataset is updated daily.

Acknowledgements

This dataset is maintained using Socrata's API and Kaggle's API. Socrata has assisted countless organizations with hosting their open data and has been an integral part of the process of bringing more data to the public.

Cover photo by Markus Spiske on Unsplash
Unsplash Images are distributed under a unique Unsplash License.

This dataset is distributed under NA

This data set accompanies the Profile of the California Medicare Population chartbook, published by the Office of Medicare Innovation and Integration in February 2022, and available at (https://www.dhcs.ca.gov/services/Documents/OMII-Medicare-Databook-February-18-2022.pdf). The three data files in this data set were analyzed from federal administrative data (the Medicare Master Beneficiary Summary File) for beneficiary characteristics as of March 2021. These datasets include: Medicare enrollment, Medicare Advantage enrollment (and its converse fee-for-service Medicare enrollment), dual Medi-Cal eligibility and enrollment (and its converse Medicare-only enrollment), by county. Medicare Savings Program enrollees were considered Medicare-only and not dually enrolled in Medi-Cal. All Medicare Part C beneficiaries, including PACE, Cal MediConnect and Special Needs Plans, were considered to have Medicare Advantage.

DHCS partnered with The SCAN Foundation and ATI Advisory in 2021 and 2022 to develop a series of chartbooks that provide information about Medicare beneficiaries in California. This work is supported by a grant from The SCAN Foundation to advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, visit www.TheSCANFoundation.org.

Centers for Medicare & Medicaid Services - Nursing HomesThis feature layer, utilizing data from the Centers for Medicare & Medicaid Services (CMS), displays the locations of nursing homes in the U.S. Nursing homes provide a type of residential care. They are a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living. Per CMS, "Nursing homes, which include Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs), are required to be in compliance with Federal requirements to receive payment under the Medicare or Medicaid programs. The Secretary of the United States Department of Health & Human Services has delegated to the CMS and the State Medicaid Agency the authority to impose enforcement remedies against a nursing home that does not meet Federal requirements." This layer includes currently active nursing homes, including number of certified beds, address, and other information.Bridgepoint Sub-Acute and Rehab Capitol HillData downloaded: August 1, 2024Data source: Provider InformationData modification: This dataset includes only those facilities with addresses that were appropriately geocoded.For more information: Nursing homes including rehab servicesFor feedback, please contact: ArcGIScomNationalMaps@esri.comCenters for Medicare & Medicaid ServicesPer USA.gov, "The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. The CMS seeks to strengthen and modernize the Nation’s health care system, to provide access to high quality care and improved health at lower costs."

Context

I found this data set online while I was looking for unique data sets. We all know that there are probably inequalities in medicare by city or by state, as there are many flaws in the system. So I thought I would like to explore this data to find where those inequalities rest.

Content

The Inpatient PUF includes information on utilization, payment (total payment and Medicare payment), and hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments.

Acknowledgements

Here is where I got my data: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient2016.html

Thanks to the US gov't for the info!

Inspiration

What relationships can you find in the data? What inequalities can you find? Can you regress the data?

Hospitals Registered with MedicareThis feature layer, utilizing data from the Centers of Medicare and Medicaid Services (CMS), depicts all hospitals that are currently registered with Medicare in the U.S. Per NIH, "Since the passage of Medicare legislation in 1965, Section 1861 of the Social Security Act has stated that hospitals participating in Medicare must meet certain requirements specified in the act and that the Secretary of the Department of Health, Education and Welfare (HEW) [now the Department of Health and Human Services (DHHS)] may impose additional requirements found necessary to ensure the health and safety of Medicare beneficiaries receiving services in hospitals. On this basis, the Conditions of Participation, a set of regulations setting minimum health and safety standards for hospitals participating in Medicare, were promulgated in 1966 and substantially revised in 1986."Ascension Columbia St Mary's HospitalData currency: 11/26/2024Data modification: This data was created using the geocoding process on the CSV file.Data downloaded from: Hospital General InformationFor more information: HospitalsSupport documentation: Data dictionaryFor feedback, please contact: ArcGIScomNationalMaps@esri.comCenters of Medicare and Medicaid ServicesPer USA.gov, "The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. The CMS seeks to strengthen and modernize the Nation’s health care system, to provide access to high quality care and improved health at lower costs."

Context

This dataset contains CMS Part D Drug Spending and Utilization for calendar years 2015 - 2019.

Content

1) Brand Name 2) Generic Name 3) Manufacturer 4) Year 5) Total Spending 6) Total Dosage Units 7) Total Claims 8) Total Beneficiaries 9)Average Spending Per Dosage Unit 10) Average Spending Per Claim 11) Average Spending Per Beneficiary 12) Outlier Flag

Acknowledgements

Data was pulled from CMS.gov (https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Information-on-Prescription-Drugs/MedicarePartD)

Inspiration

What were the brands, manufacturers, and generic molecules with the highest total spend and total claims each year? What about the least total spending and total claims?

What are the top brands/molecules in the top manufacturers' portfolios? How have these brands evolved over time in terms of claims and total spending?

What disease categories are responsible for the majority of CMS spending on Part D drugs?

Medicare Spending per Beneficiary

Detailed Hospital Expense Breakdown

By Health [source]

About this dataset

This file allows healthcare executives and analysts to make informed decisions regarding how well continued improvements are being made over time so that they can understand how efficient they are fulfilling treatments while staying within budgetary constraints. Additionally, it’ll also help them map out trends amongst different hospitals and spot anomalies that could indicate areas where decisions should be reassessed as needed

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Featured Notebooks

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How to use the dataset

This dataset can provide valuable insights into how Medicare is spending per patient at specific hospitals in the United States. It can be used to gain a better understanding of the types of services covered under Medicare, and to what extent those services are being used. By comparing the average Medicare spending across different hospitals, users can also gain insight into potential disparities in care delivery or availability.

To use this dataset, first identify which hospital you are interested in analyzing. Then locate the row for that hospital in the dataset and review its associated values: value, footnote (optional), and start/end dates (optional). The Value column refers to how much Medicare spends on each particular patient; this is a numerical value represented as a decimal number up to 6 decimal places. The Footnote (optional) provides more information about any special circumstances that may need attention when interpreting the value data points. Finally, if Start Date and End Date fields are present they will specify over what timeframe these values were aggregated over.

Once all relevant data elements have been reviewed successively for all hospitals of interest then comparison analysis among them can be conducted based on Value, Footnote or Start/End dates as necessary to answer specific research questions or formulate conclusions about how Medicare is spending per patient at various hospitals nationwide

Research Ideas

• Developing a cost comparison tool for hospitals that allows patients to compare how much Medicare spends per patient across different hospitals.
• Creating an algorithm to help predict Medicare spending at different facilities over time and build strategies on how best to manage those costs.
• Identifying areas in which a hospital can save money by reducing unnecessary spending in order to reduce overall Medicare expenses

Acknowledgements

If you use this dataset in your research, please credit the original authors. Data Source

License

License: Dataset copyright by authors - You are free to: - Share - copy and redistribute the material in any medium or format for any purpose, even commercially. - Adapt - remix, transform, and build upon the material for any purpose, even commercially. - You must: - Give appropriate credit - Provide a link to the license, and indicate if changes were made. - ShareAlike - You must distribute your contributions under the same license as the original. - Keep intact - all notices that refer to this license, including copyright notices.

Columns

File: Medicare_hospital_spending_per_patient_Medicare_Spending_per_Beneficiary_Additional_Decimal_Places.csv | Column name | Description | |:---------------|:--------------------------------------------------------------------------------------| | Value | The amount of Medicare spending per patient for a given hospital or region. (Numeric) | | Footnote | Any additional notes or information related to the value. (Text) | | Start_Date | The start date of the period for which the value applies. (Date) | | End_Date | The end date of the period for which the value applies. (Date) |

Acknowledgements

If you use this dataset in your research, please credit the original authors. If you use this dataset in your research, please credit Health.

This historic dataset with total enrollment in separate CHIP programs by month and state was created to fulfill reporting requirements under section 1902(tt)(1) of the Social Security Act, which was added by section 5131(b) of subtitle D of title V of division FF of the Consolidated Appropriations Act, 2023 (P.L. 117-328) (CAA, 2023). For each month from April 1, 2023, through June 30, 2024, states were required to submit to CMS (on a timely basis), and CMS was required to make public, certain monthly data, including the total number of beneficiaries who were enrolled in a separate CHIP program. Accordingly, this historic dataset contains separate CHIP enrollment by month and state between April 2023 and June 2024. CMS will continue to publicly report separate CHIP enrollment by month and state (beyond the historic CAA/Unwinding period) in a new dataset, which is available at [link]. Please note that the methods used to count separate CHIP enrollees differ slightly between the two datasets; as a result, data users should exercise caution if comparing separate CHIP enrollment across the two datasets. Sources: T-MSIS Analytic Files (TAF) and state-submitted enrollment totals. The data notes indicate when a state’s monthly total was a state-submitted value, rather than from T-MSIS.TAF data were pulled as follows:April 2023 enrollment - TAF as of August 2023May 2023 enrollment - TAF as of August 2023June 2023 enrollment - TAF as of September 2023July 2023 enrollment - TAF as of October 2023August 2023 enrollment - TAF as of November 2023September 2023 enrollment - TAF as of December 2023October 2023 enrollment - TAF as of January 2024November 2023 enrollment - TAF as of February 2024December 2023 enrollment - TAF as of March 2024January 2024 enrollment - TAF as of April 2024February 2024 enrollment - TAF as of May 2024March 2024 enrollment - TAF as of June 2024April 2024 enrollment – TAF as of July 2024May 2024 enrollment – TAF as of August 2024June 2024 enrollment – TAF as of September 2024 TAF are produced one month after the T-MSIS submission month. For example, TAF as of August 2023 is based on July T-MSIS submissions. Notes: The separate CHIP enrollment in this report is not inclusive of enrollees covered by Medicaid expansion CHIP. Enrollment includes individuals enrolled in separate CHIP at any point during the month but excludes those enrolled in both Medicaid and separate CHIP during the month. See the Data Sources and Metrics Definitions Overview document for a full description of the data sources, metric definitions, and general data limitations.Alaska, District of Columbia, Hawaii, New Hampshire, New Mexico, North Carolina, North Dakota, Ohio, South Carolina, Vermont, and Wyoming do not have separate CHIP Programs. Maryland has a separate CHIP program that began in July 2023; April 2023 - June 2023 data for Maryland represents retroactive coverage. This document includes separate CHIP data submitted to CMS by states via T-MSIS or a separate collection form. These data include reporting metrics consistent with section 1902(tt)(1) of the Social Security Act.CHIP: Children's Health Insurance Program Data notes: (a) State-submitted value; data not from T-MSIS(b1) May 2023 enrollment pulled from TAF as of September 2023(b2) Data was restated using TAF as of October 2023(b3) Data was restated using TAF as of April 2024(b4) Data was restated using TAF as of July 2024(b5) Data was restated using TAF as of August 2024(c) Enrollment counts include postpartum women with coverage funded via a Health Services Initiative

The dataset contains information about the prevalence of chronic conditions among Original Medicare beneficiaries as well as about the spending and co-occurring conditions for those with each condition. The data are available for California and for the rest of the United States, overall and by demographic and geographic groups. Additionally, the data are available for each of 19 California geographic regions overall and by demographic and geographic groups. The data represent Medicare beneficiaries who are in the Original Medicare program. Medicare offers health care coverage for older adults and certain individuals with disabilities. The Original Medicare program is Parts A and B of Medicare, administered by the U.S. Centers for Medicare & Medicaid Services. The analysis excludes enrollees of the Medicare Advantage program, administered by private insurers, because Medicare Advantage data are incomplete.

Metrics from individual Marketplaces during the current reporting period. The report includes data for the states using State-based Marketplaces (SBMs) that use their own eligibility and enrollment platforms Source: State-based Marketplace (SBM) operational data submitted to CMS. Each monthly reporting period occurs during the first through last day of the reported month. SBMs report relevant Marketplace activity from April 2023 (when unwinding-related renewals were initiated in most SBMs) through the end of a state’s Medicaid unwinding renewal period and processing timeline, which will vary by SBM. Some SBMs did not receive unwinding-related applications during reporting period months in April or May 2023 due to renewal processing timelines. SBMs that are no longer reporting Marketplace activity due to the completion of a state’s Medicaid unwinding renewal period are marked as NA. Some SBMs may revise data from a prior month and thus this data may not align with that previously reported. For April, Idaho’s reporting period was from February 1, 2023 to April 30, 2023. Notes: This table represents consumers whose Medicaid/CHIP coverage was denied or terminated following renewal and 1) whose applications were processed by an SBM through an integrated Medicaid, CHIP, and Marketplace eligibility system or 2) whose applications/information was sent by a state Medicaid or CHIP agency to an SBM through an account transfer process. Consumers who submitted applications to an SBM that can be matched to a Medicaid/CHIP record are also included. See the "Data Sources and Metrics Definition Overview" at http://www.medicaid.gov for a full description of the differences between the SBM operating systems and resulting data metrics, measure definitions, and general data limitations. As of the September 2023 report, this table was updated to differentiate between SBMs with an integrated Medicaid, CHIP, and Marketplace eligibility system and those with an account transfer process to better represent the percentage of QHP selections in relation to applicable consumers received and processed by the relevant SBM. State-specific variations are: - Maine’s data and Nevada’s April and May 2023 data report all applications with Medicaid/CHIP denials or terminations, not only those part of the annual renewal process. - Connecticut, Massachusetts, and Washington also report applications with consumers determined ineligible for Medicaid/CHIP due to procedural reasons. - Minnesota and New York report on eligibility and enrollment for their Basic Health Programs (BHP). Effective April 1, 2024, New York transitioned its BHP to a program operated under a section 1332 waiver, which expands eligibility to individuals with incomes up to 250% of FPL. As of the March 2024 data, New York reports on consumers with expanded eligibility and enrollment under the section 1332 waiver program in the BHP data. - Idaho’s April data on consumers eligible for a QHP with financial assistance do not depict a direct correlation to consumers with a QHP selection. - Virginia transitioned from using the HealthCare.gov platform in Plan Year 2023 to an SBM using its own eligibility and enrollment platform in Plan Year 2024. Virginia's data are reported in the HealthCare.gov and HeathCare.gov Transitions Marketplace Medicaid Unwinding Reports through the end of 2024 and is available in SBM reports as of the April 2024 report. Virginia's SBM data report all applications with Medicaid/CHIP denials or terminations, not only those part of the annual renewal process, and as a result are not directly comparable to their data in the HealthCare.gov data reports. - Only SBMs with an automatic plan assignment process have and report automatic QHP selections. These SBMs make automatic plan assignments into a QHP for a subset of individuals and provide a notification of options regarding active selection of an alternative plan and/or, if appli

Hospitals Registered with MedicareThis feature layer, utilizing data from the Centers of Medicare and Medicaid Services (CMS), depicts all hospitals that are currently registered with Medicare in the U.S. Per NIH, "Since the passage of Medicare legislation in 1965, Section 1861 of the Social Security Act has stated that hospitals participating in Medicare must meet certain requirements specified in the act and that the Secretary of the Department of Health, Education and Welfare (HEW) [now the Department of Health and Human Services (DHHS)] may impose additional requirements found necessary to ensure the health and safety of Medicare beneficiaries receiving services in hospitals. On this basis, the Conditions of Participation, a set of regulations setting minimum health and safety standards for hospitals participating in Medicare, were promulgated in 1966 and substantially revised in 1986."Ascension Columbia St Mary's HospitalData currency: 9/22/2021Data modification: this data was created using the geocoding process on the CSV file.Data downloaded from: Hospital General InformationFor more information: HospitalsFor feedback, please contact: ArcGIScomNationalMaps@esri.comThumbnail image courtesy of Tim EvansonCenters of Medicare and Medicaid ServicesPer USA.gov, "The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. The CMS seeks to strengthen and modernize the Nation’s health care system, to provide access to high quality care and improved health at lower costs."

The Public Provider Enrollment data for Medicare fee-for-service includes providers who are actively approved to bill Medicare. This dataset contains an enrollment ID crosswalk between those individual providers reassigning their benefits and those providers receiving the reassignment of benefits.

About this dataset:

-This data is a compilation of the CMS Medicare Part B National Summary Data for CPT/HCPCS Medicine Codes 90281-99xx for 2000-2022. - The information in Part B National Summary Data Files is limited to Medicare Fee-For- Service (FFS) Part B Physician/Supplier data. It does not include information on physician/supplier services for beneficiaries in the managed care portion of the program (Medicare Advantage). -Items/columns include: year, HCPCS/CPT, total annual allowed services, total annual allowed charges, and total annual allowed payment. - These are national annual aggregates. - Note that, per CMS, fields labeled “N/A” mean that the data cannot be disclosed due to Privacy rules. Cell sizes less than 11 have been screened for privacy and replaced with N/A. A zero indicates there were no services or payments rendered for a particular code. - The .csv and .xlsx files hold the same data, just in different formats. - CPT only copyright 2000-2022 American Medical Association. All rights reserved.

Column Descriptions:

Allowed Services: A count of the number of services performed for a procedure.

Allowed Charges: The amount Medicare determines to be reasonable payment for a provider or service covered under Part B. This includes the coinsurance and deductible amounts.

Description: The category corresponding to the HCPCS code, for example: Evaluation and Management, Anesthesia, Dental Services, Pathology/Lab Tests, Chemotherapy Drugs, Medicine, etc

HCPCS (Healthcare Common Procedure Coding System): The HCPCS is a coding system for all services performed by a physician or supplier. It is based on the American Medical Association Physicians Current Procedural Terminology (CPT) codes and is augmented with codes for physician and non-physician services (such as ambulance and durable medical equipment (DME), which are not included in CPTs.

Modifiers: Modifiers denote that a certain procedure/service has been altered by a particular circumstance, but not changed in its definition, therefore the same code is used and a modifier is added to denote what has been altered.

Payment: In the Original Medicare Plan, this is the amount a doctor or supplier that accepts assignment can be paid. It includes what Medicare pays and any deductible, coinsurance, or copayment that the beneficiary must pay. It may be less than the actual amount a doctor or supplier charges.

Additional details can be found in the Medicare Part B National Summary Data Read Me files: file:///C:/Users/sybil/AppData/Local/Temp/3dce003b-ea02-4b37-aaae-c4ef3e6f43a9_PartBNational2010.zip.3a9/PartBNationalSummaryReadmeFile2010.pdf

CMS Data Disclaimer

CMS has no responsibility for the data after it has been converted, processed or otherwise altered. Data that has been manipulated or reprocessed by the user is the responsibility of the user. The user may not present data that has been altered in any way as CMS data. Any alteration of the original data, including conversion to other media or other data formats, is the responsibility of the requestor. Cell sizes less than 11 have been screened for privacy and replaced with N/A. A zero indicates there were no services or payments rendered for a particular code.

ANY USE OF THIS DATA IS AN ACCEPTANCE OF THE FOLLOWING END USER AGREEMENT:

*End User Agreement:

License for Use of Current Procedural Terminology, ANY Edition ("CPT®")

CPT codes, descriptions and other data only are copyright 1995 - 2023 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of Centers for Medicare and Medicaid Services (CMS) internally within your organization within the United States for the sole use by yourself, employees and agents. Use is limited to use in Medicare, Medicaid or other programs administered by CMS. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza, 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. Applications are available at the AMA Web site, http://www.ama-assn.org/go/cpt. Applicable FARSDFARS Restrictions Apply to Government Use

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial c...

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