- API data.cms.gov | Last Updated 2020-03-30T20:49:53.000Z
Order and Referring data file has National Provider Identifier (NPI) and legal name (last name, first name) of all physicians and non-physician practitioners who are of a type/specialty that is legally eligible to order and refer in the Medicare program and who have current enrollment records in Medicare (i.e., they have enrollment records in PECOS)
- API data.cms.gov | Last Updated 2020-03-17T20:32:17.000Z
A list of practitioners who are currently opted out of Medicare. This dataset was last updated on March 5th, 2020 and will be updated next on or around March 20, 2020 tentatively. For an interactive Search Tool for Opt-Out Affidavits please visit: https://data.cms.gov/opt-out-affidavits Frequently Asked Questions (FAQ): https://data.cms.gov/opt-out-affidavits/faqs There are 151 providers (~0.60%) of all current opt-out providers with an NPI billing for emergency / urgent care during opt out period.
- API data.cms.gov | Last Updated 2019-08-16T18:58:43.000Z
This data set presents Metropolitan Statistical Areas (MSAs) that are participating in the Comprehensive Care for Joint Replacement Model, a proposed model to support better and more efficient care for beneficiaries undergoing the most common inpatient surgery for Medicare beneficiaries: hip and knee replacements.
Inpatient Prospective Payment System (IPPS) Provider Summary for the Top 100 Diagnosis-Related Groups (DRG) - FY2011data.cms.gov | Last Updated 2017-08-30T17:50:04.000Z
6/2/14 UPDATE: Original FY2011 data file has been updated to include a new column, "Average Medicare Payment." The data provided here include hospital-specific charges for the more than 3,000 U.S. hospitals that receive Medicare Inpatient Prospective Payment System (IPPS) payments for the top 100 most frequently billed discharges, paid under Medicare based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG) for Fiscal Year (FY) 2011. These DRGs represent more than 7 million discharges or 60 percent of total Medicare IPPS discharges. For more information, see https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Inpatient2011.html.
- API data.cms.gov | Last Updated 2020-01-16T18:40:13.000Z
This file is a point in time snapshot of enrollment level data for providers actively enrolled in Medicare.
- API data.cms.gov | Last Updated 2020-02-28T23:11:34.000Z
Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers/suppliers to revalidate their Medicare enrollment information under new enrollment screening criteria. CMS has completed its initial round of revalidations and will be resuming regular revalidation cycles in accordance with 42 CFR §424.515. In an effort to streamline the revalidation process and reduce provider/supplier burden, CMS has implemented several revalidation processing improvements one of which is established due dates by which you must revalidate.
- API data.cms.gov | Last Updated 2019-06-28T00:37:15.000Z
The file contain the National Provider Identifier (NPI) and legal name (last name, first name) of those physicians and non-physician practitioners that are eligible to order and refer PMD and have a current enrollment record in Medicare. http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8239.pdf
- API data.cms.gov | Last Updated 2017-09-15T14:58:50.000Z
- API data.cms.gov | Last Updated 2019-10-01T17:07:13.000Z
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.
- API data.cms.gov | Last Updated 2018-01-05T19:53:23.000Z
The Medicare Shared Savings Program (Shared Savings Program) facilitates coordination among providers to improve the quality of care for Medicare fee-for-service beneficiaries while reducing the growth in health care costs. Eligible providers, hospitals, and suppliers may apply to participate in the Shared Savings Program by creating or participating in an Accountable Care Organization (ACO). Note: The yellow clusters represent the number of ACOs in an area. This area may cover organizations in multiple states. Click on the cluster to view blue dots with fly outs to see actual ACO location. DISCLAIMER: This information is current as of January 2018. Changes to ACO information occurs periodically. Each ACO has the most up-to-date information about their organization. Consider contacting the ACO for the latest information.