Physician

CMS Updates Physician Payment Information for Value-Driven Health Care (9-6-2012)

The U.S. Department of Health and Human Services is committed to making health care more affordable and accessible.  As part of this effort, the Centers for Medicare & Medicaid Services is making cost and quality data available to all Americans.  As a first step in this initiative, on June 1, 2006, Medicare posted information about the payments it made to hospitals in fiscal year 2005 for common elective procedures and other hospital admissions.  Similar postings of Medicare payment data followed during the year for Ambulatory Surgery Centers (ASCs), Hospital Outpatient Departments, and Physician Services.  This information is updated annually.

We are now presenting an update to last year's physician services data, including anesthesia services and many Medicare covered preventive services.  The information is being displayed in the same format as last year, updated with calendar year (CY) 2011 data. 

Below you will find ten zipped Microsoft Excel files.  Please note that some of the files are large so printing them is not recommended.  As a reminder, our objective is to provide the basic information for consumers and others to use and analyze at their discretion.  Consumers are encouraged to consult with their physicians if they have questions about the procedures/codes contained in any of the files.  The information is provided in Excel format in order to facilitate its use.  Please take note of the footnotes displayed at the end of each table as the footnotes will be helpful in understanding the data contained in the tables.

The first five physician files (the updated files using CY 2011 data) are as follows:

"Physician Payments:  Commonly Performed Services in a Non-Office Facility Setting" are two files which contain service volumes, and charge and Medicare payment data for physicians' services for a limited set of services, including anesthesia services, rendered in Medicare payment localities.  These particular codes/services are directly related to the types of services which may be rendered in an inpatient hospital, outpatient hospital, or ASC, and correlate to most of the procedure codes already posted.

"Physician Payments:  Other Commonly Performed Services Provided in an Office Setting" contains similar service, charge, and Medicare payment data, but for physicians' services of high utilization which are commonly performed in a physician's office.

"Physician Payments:  Medicare Preventive Services Provided in an Office Setting" also contains similar service, charge, and Medicare payment data, but for many Medicare preventive services rendered by physicians.

The fifth physician file contains a 1-page example of the comprehensive physician data.

The remaining files/documents are the same as those posted last year using CY 2010 data.

Note Regarding Current Procedural Terminology (CPT) Codes Used in the Tables:  CPT only copyright 2011 American Medical Association.  All rights reserved. Applicable Federal Acquisition Regulations System (FARS)/Defense Federal Acquisition Regulation Supplement (DFARS) Apply.  CPT is a registered trademark of the American Medical Association.