Home Health Blogger

Home Health Care Policies: New Medicare Utilization and Payment Data Available

Posted by Nathan Hope on Oct 9, 2015

New Medicare utilization and payment data available for medical equipment, supplies
Data serves as comprehensive resource for information on durable medical equipment costs and services

Home Health Care Policies- As part of the Administration’s efforts to make our healthcare system more transparent, affordable, and accountable, the Centers for Medicare & Medicaid Services (CMS) has posted a new data set as part of the Provider Utilization and Payment files. This data set, called Referring Provider Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Public Use File (PUF), provides information on physicians and other healthcare professionals who referred DMEPOS products and services, such as wheelchairs, walkers, and diabetes supplies for Medicare beneficiaries.14-11-04-CMS

“The data set made available today is part of a wider set of initiatives by the Administration to achieve better care, smarter spending, and healthier people throughout our health care system,” said Acting CMS Administrator Andrew Slavitt. “CMS is providing this data to support insight and innovations in health care delivery.”

The Referring Provider DMEPOS PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code and supplier rental indicator. This PUF was created from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program available from the CMS Chronic Condition Data Warehouse (www.ccwdata.org). CMS protects beneficiaries’ personal information in all its data releases.

The data in the Referring Provider DMEPOS PUF covers calendar year 2013 and is based on information from Part B non-institutional DMEPOS claims. These new data include information on over 385,000 providers who referred DMEPOS products in 2013. In total, the data represent over 100 million claims and $11 billion in Medicare allowed amounts.  

To view a fact sheet on the Referring Provider DMEPOS PUF, visit: http://cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-08.html.

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