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Medicare database download Enter your query below and click "search" to get started. Oct 17, 2024 · PFS Look-up Tool Overview Search the Physician Fee Schedule Documentation and Files Help Learn More PFS Quick Reference Search Guide Sample PFS Searches Status Indicators Page Last Modified: 10/17/2024 10:44 AM Help with File Formats and Plug-Ins Sep 24, 2025 · Allows you to find and download quality of care data on every Medicare and Medicaid-certified nursing home in the country, including over 15,000 nationwide. Nov 16, 2025 · You can download local and national coverage document data sets. Explore and download provider data on: Dialysis facilities Doctors and clinicians Home health services The MCD Search page is the starting point to search for Medicare Coverage documents. Our comprehensive guide outlines the steps, including requests for restricted and limited datasets or public use files. For instance, the Exchange PUF offers plan and provider-level data on claims, payments, and coverage within the Health Insurance Exchange program. gov lets you interactively analyze our datasets in real-time. Medicare. ), source of funding for those services (private health insurance, Medicare . AHRQ created SyH-DR, in part, as a resource to Mar 17, 2009 · Part D Claims Data This page contains information on Part D claims data for the purposes of research, analysis, reporting, and public health functions. The accumulation of claims submitted for the period commencing on a beneficiary's date of admission to an inpatient hospital or SNF and ending on the beneficiary’s date of discharge from that hospital or SNF represents one stay. OIG has the authority to exclude individuals and entities from Federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud. Staffing Data Submission Payroll Based Journal (PBJ) Now available! Our new Provider Data Catalog makes it easier for you to search & download our publicly reported data. This includes information on providers who accept Medicare, services and procedures delivered by providers, and qualified health plans. Download all datasets MMLEADS is a suite of linked data files for Medicare-Medicaid eligibility, enrollment, utilization, and expenditure data. Apr 10, 2024 · CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. It allows users to identify and view both National and Local Coverage documents that reside within the database. These datasets allow you to compare the quality of care provided in Medicare-certified hospitals, Veterans Administration (VA) medical centers, and Department of Defense (DoD) hospitals nationwide. It provides comprehensive access to National and Local Coverage data available on the Medicare Coverage Database (MCD). 3203 | 800. Jul 16, 2025 · Hospital General Information A list of all hospitals that have been registered with Medicare. gov lists official data used on the Medicare. See a summary of key provisions effective on or after January 1, 2026. The MCD Search page is the starting point to search for Medicare Coverage documents. Whether you choose to share your personal health information or not has no effect on your enrollment, eligibility for benefits, or the amount Medicare pays for your health services. We want to make this data available in open, accessible, and machine-readable formats. This dataset provides current as well as historic data for more than 6,000 variables for each of the nation’s counties, as well as state and national data. Each row contains a specific quality measure for a specific nursing home and includes the risk-adjusted score. If you have questions or need additional help, please use the Submit Feedback/Ask a Data. It is designed for users, such as researchers, that have a need to download the MCD data in tabular format for use in their separate workflows. The files have been constructed in accordance with current CMS and Department of Health and Human Services (HHS) policies and other applicable statutes and laws. government website for Medicare Physician Fee Schedule data. These datasets give you useful information about doctors, clinicians, and groups listed on Medicare Care Compare. Additionally, the Medicare Utilization and Payments section includes tables with Part D utilization and drug cost data, as well as tables on Medicare premiums. MedPAC also produces occasional data books on selected topics. AUTHORIZATION TO DISCLOSE PERSONAL HEALTH INFORMATION RELEASE FORM Use this form to tell 1-800-MEDICARE who can access your personal health information. What does this file include? (variable highlights)The MD-PPAS file assigns Medicare providers to medical practices based on the tax identification numbers and elaborates on the Centers for Medicare & Medicaid Services (CMS) provider specialty classification. Provider Type Provider Resides in Hospital Legal Business Name Date First Approved to Provide Medicare and Medicaid Services Chain Name Chain ID Number of Facilities in Chain Aug 13, 2025 · These are the official datasets used on Medicare. Historically, researchers have only been able to request annual extracts of Medicare claims data under the LDS request process. by type of good or service delivered (hospital care, physician and clinical services, retail prescription drugs, etc. Download all datasets Apr 17, 2025 · Medicare-certified institutional providers are required to submit an annual cost report to a Medicare Administrative Contractor (MAC). Jun 19, 2025 · The PFS Look-Up Tool gives Medicare payment information on more than 10,000 services, including pricing, associated relative value units, and payment policies. e. Download all datasets Oct 1, 2020 · These are the official datasets used on Medicare. Visit our tips page to learn how to best use the Exclusions Database. For more information on these providers, with the exception of Nursing Homes, data can be found in the Provider of Service File (POS) - Internet Quality Improvement and Evaluation System (iQIES) on Data. Summary of Medicare benefits, coverage decisions, rights and protections, and answers to the most frequently asked questions about Medicare. We’ve also improved Medicare’s compare sites. These data exchanges and query files include: Medicare Prescription Drug, Improvement, and Modernization Act (MMA) File Exchange; Territory The Centers for Medicare & Medicaid Services (CMS) makes Limited Data Set (LDS) files available to researchers as allowed by federal laws and regulations as well as CMS policy. Jul 22, 2025 · Generally, CMS public data products include a data dictionary, source methodology, and program or data contact information. This provider-level dataset is built around two identifiers: the national provider identifier (NPI) and the tax identification number (TIN). The first Synthetic PUF released is the 2008-2010 Data Entrepreneurs’ SynPUF. This includes Inpatient and Outpatient claims, Master Beneficiary Summary Files, and many other files. Sep 24, 2025 · Allows you to find and download quality of care data on every Medicare and Medicaid-certified nursing home in the country, including over 15,000 nationwide. These datasets contain information on total number of prescriptions dispensed, and the total drug cost by National Provider Identifier (NPI), prescription drug, and geography. Sep 10, 2024 · Access to CMS Data & Application CMS Contractor Data Communications Support Policy Medicare fiscal intermediaries and carriers shall use the Government furnished Medicare Data Communications Network (MDCN) to support all Medicare operational data connectivity requirements. Sep 28, 2025 · Medicare Claims Quality Measures Quality measures that are based on Medicare claims data. Initiate your request by submitting a Research Identifiable Files (RIF) request and a Data Use Agreement (DUA). Claims data include type of service, procedures, diagnoses, dates of service, charge amounts, and payment amounts. MedPAR consolidates Inpatient Hospital or Skilled Nursing Facility (SNF) claims data from the National Claims History (NCH) files into stay level records. However, publicly reported data, including star ratings, should not be construed as an endorsement by the U. The OASIS-E2 Change Table is also available in the Downloads section, below, which notes the changes from the current version, OASIS-E1, to the proposed next version OASIS-E2. A nursing home is a place for people who can’t be cared for at home Feb 20, 2024 · Learn the process of obtaining CMS data for your research through ResDAC. This page will be updated when:An update is made to these resources. cms. Nov 15, 2024 · Introduction to the Downloads This document provides an overview of the MCD data sets including how to download, understand, and use the data sets and associated files. CMS provides this service based on federal law (45 CFR Part 162). 2326 TTY | email. government website that houses data collected and published by Open Payments, a federally mandated program that collects information about payments that reporting entities, including drug and medical device companies make to covered recipients like physicians. If you create a Medicare account, you can download your Medicare claims data to your computer or device to print it or share it with someone you trust to help you. Sep 24, 2025 · Utilization Data The Doctors and Clinicians utilization data file reports volume information for procedures of interest on clinician profile pages and in the provider data catalog (PDC) to inform patients and caregivers about clinicians' experience. Aug 14, 2025 · Timely and Effective Care - Hospital Timely and Effective Care measures - provider data. Overview CMS offers a wide variety of data products on Medicare enrollees. To achieve this, we rely directly on data published by the Centers for Medicare & Medicaid Services (CMS), the official source of Medicare plan and enrollment information. What do you want to do? Forms Get Medicare forms for different situations, like filing a claim or appealing a coverage decision. Each zip package contains a Read Me file, the data set, and a data dictionary. The official U. Medicare fee-for-service data by state for ESRD dialysis beneficiaries. In addition, the basic file Aug 2, 2025 · Nursing Home Compare has detailed information about every Medicare and Medicaid nursing home in the country. The official update of the HCPCS code system is available as a public use file below. In addition, the basic file Nov 5, 2025 · Medicare HOS Public Use Data Files (PUFs) To facilitate the dissemination of data collected by the Medicare HOS project for additional research, PUFs have been created for each cohort of data. Physician Fee Schedule: CY 2026 Final Rule – Learn What's New CMS issued the CY 2026 Physician Fee Schedule (PFS) final rule that announces final policy changes for Medicare payments under the PFS and other Medicare Part B issues. While health plan information including benefits, copayments, premiums, and geographic coverage is publicly available on Healthcare. Data is provided by state and then by DRG for all short stay and inpatient hospitals for fiscal years 2005-2007. Using this feature, you can download local and national coverage document data sets. Sep 11, 2025 · The Medicare Part D Prescribers by Provider dataset contains information on prescription drugs prescribed by individual physicians and other health care providers and paid for under the Medicare Part D Prescription Drug Program. Feb 22, 2016 · Scope The Public Provider Enrollment files will include enrollment information for providers and suppliers who were approved to bill Medicare at the time the file was created. Clinicians with multiple Medicare enrollment records and/or single enrollments linking to multiple practice locations are listed on multiple lines. Attention QCOR users If you require assistance using the QCOR application, please contact the QCOR Help Desk. Access methods include direct downloads, interactive views, and application programming interfaces (APIs). We also supply this directory in a full download file, or through an Application Programming Interface (API). May 15, 2025 · PFS Relative Value Files This information relates to payment under the Medicare physician fee schedule and is intended for Medicare purposes. These data will also be used to better identify, evaluate and measure the effects of the Medicare Modernization Act of 2003, (MMA). The Centers for Medicare & Medicaid Services (CMS) makes PUFs freely available for download. Important information regarding these tools needs to be communicated. The Medicare Shared Savings Program (Shared Savings Program) makes data on Accountable Care Organizations (ACOs) publicly available through different sources. Download the Data Learn about the data, systems, and research behind the programs that provide health coverage to more than 100 million people. Enrollment data include date of birth, sex, race or ethnicity, and reason for entitlement. , payment of assistant at surgery, team Sep 10, 2024 · Files will be made available as a free downloads in order to provide access to Medicare data without the time and cost associated with obtaining data files which require more restricted access. Nov 5, 2025 · A series of datasets that provide information on prescription drugs prescribed by individual physicians and other healthcare professionals and paid for under the Medicare Part D Prescription Drug program. Department of Health and Human Services (HHS) of any health care Jan 6, 2022 · Cost Report Data provides hospital financial information from Medicare cost reports filed by hospitals and contained in the CMS HCRIS file. 6 days ago · This page provides information on Medicare providers and suppliers, including ordering and referring eligibility and enrollment requirements. The Centers for Medicare & Medicaid Services (CMS) publicly reports Quality Payment Program (QPP) performance information, if available, for individual clinicians, groups, and Accountable Care Organizations (ACOs) on the Doctors and Clinicians sections of the Medicare. Provider Data Service The Provider Data Service enables public access to the Provider Specific File, which drives payment calculations for the 16,000 Medicare-participating hospitals and institutions nationwide. Jul 17, 2025 · Data Book The MedPAC annual data book, "Health Care Spending and the Medicare Program," is a chart book that provides tables and graphs describing the Medicare program, Medicare beneficiaries and their utilization of health care services, and Medicare’s payment systems. Our goal is to make our data readily available in open, accessible, and machine-readable formats. gov, CMS also publishes downloadable public use files (PUFs) so that Hover over or select attributes to display Medicare data for a state/territory, or county (ies) or ZIP Code (s) within a state/territory, and natural hazard data. Dec 6, 2022 · UpdatesAugust 12, 2025NOW AVAILABLE – Draft OASIS-E2 Instruments and OASIS-E2 Change TableThe draft versions of the OASIS-E2 instruments are available in a zip file in the Downloads section, below. Sep 10, 2024 · Overview of File: The Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files contain formulary, pharmacy network, and pricing data for Medicare Prescription Drug Plans and Medicare Advantage (MA) Prescription Drug Plans (with the exception of employer and Program of All-Inclusive Care for the Elderly plans). government are in the public domain, and permission is not required to use them. Fees can be from different years, carriers, or procedure codes. Apr 11, 2025 · NATIONAL PHYSICIAN FEE SCHEDULE AND RELATIVE VALUE FILES This file contains information on services covered by the Medicare Physician Fee Schedule (MPFS). This data set includes provider-level data for measures of cataract surgery outcome, colonoscopy follow-up, emergency department care, preventive care, and pregnancy and delivery care. The Synthetic Healthcare Database for Research (SyH-DR) is an all-payer, nationally representative claims database. The data dictionaries in the download files explain the content and use of each database. This data will focus on data relationships as they relate to Medicare Provider Enrollment. For the latest updates, please visit the Release Notes page, a link to which can be found further down on this page. For a clinician or group's information to appear on Care Compare, they must have 6 days ago · CMS Program Use & Payments Provider Summary by Type of Service This series of public data files summarize the use and payments for procedures, services, and prescription drugs provided to Original Medicare (fee-for-service) beneficiaries by specific inpatient and outpatient hospitals, long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, home health This dataset provides current as well as historic data for more than 6,000 variables for each of the nation’s counties, as well as state and national data. Medicare. Jul 17, 2025 · The National Center for Health Statistics (NCHS) Data Linkage Program links NCHS survey data with data from the Centers for Medicare & Medicaid Services (CMS). For most available data, you can: Download data in a variety of formats. gov has datasets about Medicare Fee-For-Service, special programs and initiatives, and the Health Insurance Marketplace. The Medicare claims data released by CMS is organized by an individual physician’s National Provider Identifier (NPI) and Healthcare Common Procedure Coding System code. The data includes: Name, address, gender and specialty Number and type of services provided Number of Medicare patients treated Average and standard deviation in charges Allowed amount Total amount paid by Medicare CMS does Oct 28, 2025 · This look-up tool is a searchable database that allows you to look up a provider by National Provider Identifier (NPI), or by name and location. Oct 17, 2024 · PFS Look-up Tool Overview Search the Physician Fee Schedule Documentation and Files Help Learn More PFS Quick Reference Search Guide Sample PFS Searches Status Indicators Page Last Modified: 10/17/2024 10:44 AM Help with File Formats and Plug-Ins Open NPI database of active providers in a powerful spreadsheet. Find the answers you need. Sep 11, 2025 · National Downloadable File The Doctors and Clinicians national downloadable file is organized such that each line is unique at the clinician/enrollment record/group/address level. The list includes addresses, phone numbers, hospital type, and overall hospital rating. hhs. gov lets you download and explore data behind ratings on Medicare. Centers for Medicare & Medicaid Services Data Explorer Browse, filter and download healthcare datasets from CMS Total: 4134 | Filtered: 4134 Data. A newer version becomes available. Nov 6, 2025 · Public Use Files These Public Use Files (PUFs) provide detailed insights into complex healthcare processes. May 24, 2025 · The Medicare Inpatient Hospitals by Provider and Service dataset provides information on inpatient discharges for Original Medicare Part A beneficiaries by IPPS hospitals. Researchers now have the option of requesting LDS claims on an annual or quarterly basis making it easier to do the important research that will lay the foundation for better quality and lower costs in the health care Jan 10, 2025 · Medicare fee-for-service data by county for non-ESRD aged and disabled beneficiaries combined. Data. December 23, 2024NOW Jun 19, 2025 · The PFS Look-Up Tool gives Medicare payment information on more than 10,000 services, including pricing, associated relative value units, and payment policies. Developer tools from Centers for Medicare & Medicaid Services Use our collection of APIs, datasets, frameworks, and style guides to develop applications that help people get the services and benefits they rely on. gov provided by the Centers for Medicare & Medicaid Services. Accept the ADA/AMA/NUBC license agreements Aug 14, 2025 · These are the official datasets used on Medicare. Download publicly available Medicare data from the Dartmouth Atlas DATA site, part of the Dartmouth Atlas of Health Care. This data source includes health care information for all dually eligible Medicare-Medicaid enrollees, and, for comparison purposes, all Medicare-only beneficiaries and Medicaid-only beneficiaries with disabilities. For more than 10,000 physician services, the file contains the associated relative value units, a fee schedule status indicator, and various payment policy indicators needed for payment adjustment (i. The Centers for Medicare & Medicaid Services (CMS) Center for Consumer Information and Insurance Oversight (CCIIO) is committed to increasing transparency in the Health Insurance Exchanges. These datasets are essential for informed decision-making and improving healthcare services. Altas DATA offers access to decades worth of Medicare data, as well as supplemental materials including crosswalks and geographic boundary files. Download all datasets Sep 24, 2025 · These are the official datasets used on Medicare. Using this feature, you can download Data Sets containing all the Local Coverage Documents (Articles and LCDs) or the National Coverage Documents (NCDs and Public Comments for NCAs/CALs) used by the Medicare Coverage Database website. These non-identifiable files are available on a monthly and The Medicare Utilization and Payments section includes tables with utilization and payment data for the following service types: inpatient hospital, skilled nursing facility, home health agency, hospice, outpatient, and physician/supplier. The focus of this brief review is Medicare claims data, representing claims for the various types of services that Medicare pays for, including inpatient and outpatient utilization, prescription drug purchases through the Part D program, home health services, and more. This page provides Medicare provider enrollment data for transparency and research purposes. Publicly available datasets for research and transparency. If you are a provider with questions about your record, our Enumerator can assist you: 800. Download selected Medicare data in the table below. This information is updated twice a month. It contains information on health facilities, health professions, measures of resource scarcity, health status, economic activity, health training programs, and socioeconomic and environmental characteristics. View and analyze data using interactive tools. CMS. Please check the “Updates” section at the bottom of this webpage periodically for updates on the latest activities. gov compare tool profile pages and in the Provider Data Catalog. For a clinician or group's information to appear on Care Compare, they must have 6 days ago · CMS Program Use & Payments Provider Summary by Type of Service This series of public data files summarize the use and payments for procedures, services, and prescription drugs provided to Original Medicare (fee-for-service) beneficiaries by specific inpatient and outpatient hospitals, long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, home health 6 days ago · The ICD-9 and ICD-10 valid and excluded diagnosis codes for the latest fiscal year are made available to non-group health plan (NGHP) responsible reporting entities (RREs) and agents for Section 111 liability insurance (including self-insurance), no-fault, and workers’ compensation mandatory reporting. If you experience technical difficulties, please email the webmaster at webmaster@oig. gov. Feb 3, 2025 · Medicare Program Integrity Manual, Chapter 13 - Local Coverage Determinations (PDF) LCD What's New Report (Local Coverage Documents (LCDs) and Articles that were updated in the most recent Medicare Coverage Database (MCD) weekly update) 5 days ago · This page includes the current versions of the IRF-PAI, the IRF-PAI Manual, and associated documents. The Medicare-Medicaid Coordination Office revised the IEA and DRA to support merging authorization of Browse categories to explore Medicare and Medicaid data from the Centers for Medicare & Medicaid Services. All datasets are API-enabled, supporting integration with external websites and applications. The data elements on the files are open to the public. Describes how to access the SEER Data, including the research data agreements and authorization steps. Find the most recent data on this webpage and Data. Find, view & download datasets, tools and more using the Centers for Medicare & Medicaid Services Data search. General information General information about doctors and clinicians in the Provider Data Catalog and on Medicare Care Compare profile pages comes primarily from the Provider, Enrollment, Chain, and Ownership System (PECOS) and is checked against Medicare claims data. PECOS supports the Medicare Provider and Supplier enrollment process by allowing registered users to securely and electronically submit and manage Medicare enrollment information. Using the Downloads Tab To access the Downloads feature, click Downloads in the top navigation bar. CMS is pleased to announce the availability of the Enrollee-Level External Data Gathering Environment (EDGE) Limited Data Set (LDS) for the 2023 benefit year to requesters who seek the data for research purposes. Oct 1, 2025 · The official U. Lookup NPI data from NPPES NPI registry for free via Medicare Provider Enrollment Files. 465. Explore interactive tools and data on healthcare providers, geographic activity, and more with the Centers for Medicare & Medicaid Services. CMS provides state and territory Medicaid agencies with multiple data exchanges and query files to support coordination and program operations for people who are dually eligible for Medicare and Medicaid, also known as dually eligible beneficiaries. Using government data Works of the U. Effective date is noted in the file title. CMS has included all of the necessary data elements in the 2552-10 Medicare Cost Report Public Use File to recreate full Medicare cost reports. S. Linking NCHS data with CMS Medicare data files enables researchers to study changes in health and health care. An attribution to the Centers for Medicare & Medicaid Services (CMS) as the source is appreciated. Oct 22, 2025 · It walks viewers through downloading datasets and more. The database consists of a sample of inpatient, outpatient, and prescription drug claims, including utilization, payment, and enrollment data, for people insured by Medicare, Medicaid, or commercial health insurance in 2016. Learn about the timeline and approval process for various request types, including DUA Overview The Medicare Coverage API is an application programming interface (API) designed to provide developers with access to Medicare coverage data. The database has complete PDF versions of the recreated cost reports available to view or download. Use CMS' extensive searchable databases to look-up hospitals, prescribers, physicians and supplier information. The look-up tool will return information on services and procedures provided to beneficiaries enrolled in Original Medicare (fee-for-service). These datasets allow you to compare the quality of care provided in Medicare-certified home health services nationwide. The older versions of these documents will remain available for reference in the IRF Quality Reporting Program Archives. Public Use Files (PUFs) are non-identifiable data that do not contain any protected health information (PHI) or personally identifiable information (PII). government website for Medicare, a health insurance program for people age 65 or older and younger people with disabilities. All identifying information has been Data include claims information for services furnished to Medicare beneficiaries and Medicare enrollment data. The cost report contains provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data. 692. Explore and download provider data on: Dialysis facilities Doctors and clinicians Home health services Explore, download, and investigate data on: Drug Pricing and Payment Data on drug pricing, use, and compliance for Medicaid/Medicare, offering transparency into costs, manufacturer practices, and reimbursement processes. We would like to show you a description here but the site won’t allow us. These datasets allow you to compare the average level of a nursing home's performance in certain areas of care for Medicare-certified skilled nursing facilities and nursing homes nationwide. org is committed to providing visitors with accurate, up-to-date, and trustworthy information about Medicare Advantage, Part D, and Special Needs Plans. Hospitals report data to the Centers for Medicare & Medicaid Services (CMS) through the Hospital Inpatient Quality Reporting (IQR) Program, Hospital Outpatient Quality Reporting (OQR) Program, Hospital Readmission Reduction Program (HRRP), Hospital-Acquired Condition (HAC) Reduction Program, and Hospital Value-Based Purchasing (VBP) Program. Sep 22, 2025 · National Health Expenditures home pageNational Health Expenditure Accounts are comprised of the following: National Health Expenditures Historical spending measures annual health spending in the U. The State Data Resource Center (SDRC) hosted a webinar to discuss the release of the new, streamlined Information Exchange Agreement (IEA) and Data Request Attestation (DRA) documents for sharing and exchanging Medicare data with state Medicaid agencies for the dually eligible population. MEDPAR files contain information for 100% of Medicare beneficiaries using hospital inpatient services. Forms, Publications, & Mailings Download a form, learn more about a letter you got in the mail, or find a publication. gov Compare websites and directories. About This site gives you direct access to public data released by the Centers for Medicare & Medicaid Services (CMS). Each download zip package contains a Read Me file, a data set, and an associated Data Dictionary. This lookup tool allows you to view and compare up to five fees directly in your browser. bba nmkmiu hqyvgd lgi kyvepxw uwcerwe pvpr cyxj wojfk zbbouo enclmhjn mnv gvbkouj ictod uyzbvz