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CMS data

CMS provides extensive data to the public as part of our commitment to transparency in our operations. This data also helps members of the public, researchers and media organizations access information for analysis.

Here are some links to CMS data sources:

CMS Data Navigator
The CMS Data Navigator application is an easy-to-use, menu-driven search tool that makes the data and information resources of the Centers for Medicare and Medicaid Services (CMS) more easily available. Use the Data Navigator to find data and information products for specific CMS programs, such as Medicare and Medicaid, or on specific health care topics or settings-of-care. This data tool helps users filter publicly available data sets by such categories as geography, health care setting and document types. We also recommend signing up for email updates to learn when new data is available.

CMS Fast Facts
CMS has developed a new quick reference statistical summary on annual CMS program and financial data.  CMS Fast Facts includes summary information on total program enrollment, utilization, expenditures, as well as total number of Medicare providers including physicians by specialty area. This feature is updated frequently as new data become available. Please check back often.

CMS Program Statistics
CMS Program Statistics includes detailed summary statistics on national health care, Medicare populations, utilization, and expenditures, as well as counts for Medicare-certified institutional and non-institutional providers.

CMS Statistics Reference Booklet
The annual CMS Statistics reference booklet provides a quick reference for summary information about health expenditures and the Medicare and Medicaid health insurance programs. The CMS Statistics reference booklet is published in June of each calendar year and represents the most currently available information at the time of publication. CMS Statistics reference booklets are available for 2003 through the most currently available complete calendar year.

Cohort Estimate Tool
This application allows for the estimation of Medicare and Medicare-Medicaid population sizes. It does not allow for estimation of populations for Medicaid-only enrollees. Medicare population estimates are extrapolated from the 20% Medicare sample from 2012.

Data.Medicare.gov
Offers the ability to download and explore data behind ratings on Medicare.gov.

Data.CMS.gov
This site allows real-time, interactive analysis of CMS datasets. All datasets are API-enabled, supporting integration with external websites and applications.

Medicare Provider Utilization and Payment Data: Physician and Other Supplier Look-up Tool
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. The look-up tool will return information on services and procedures provided to Medicare beneficiaries, including utilization information, payment amounts (allowed amount and Medicare payment), and submitted charges organized by Healthcare Common Procedure Coding System (HCPCS) code. The data covers calendar year 2012 and contains 100% final-action physician/supplier Part B non-institutional line items for the Medicare fee-for-service population (information is redacted where necessary to protect beneficiary privacy).

Medicare Provider Utilization and Payment Data: Inpatient Hospital
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 and 2012. These DRGs represent more than 7 million discharges or 60 percent of total Medicare IPPS discharges.

Hospitals determine what they will charge for items and services provided to patients and these charges are the amount the hospital bills for an item or service. The Total Payment amount includes the MS-DRG amount, bill total per diem, beneficiary primary payer claim payment amount, beneficiary Part A coinsurance amount, beneficiary deductible amount, beneficiary blood deducible amount and DRG outlier amount.

Medicare Provider Utilization and Payment Data: Outpatient Hospital
The data provided here include estimated hospital-specific charges for 30 Ambulatory Payment Classification (APC) Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for Calendar Years (CY) 2011 and 2012.  The Medicare payment amount includes the APC payment amount, the beneficiary Part B coinsurance amount and the beneficiary deductible amount.

Medicare and Medicaid Statistical Supplement
Includes 115 tables and 67 charts describing health expenditures for the entire U.S. population, characteristics of the Medicare and Medicaid covered populations, use of services, and expenditures under these programs.

National Health Expenditures
National Health Expenditures looks at historical annual health spending in the U.S. by type of good or service delivered (hospital care, physician and clinical services, retail prescription drugs, etc.) and source of funding for those services (private health insurance, Medicare, Medicaid, out-of-pocket spending, etc.) Projections are based on the National Health Expenditures and are estimates of spending for health care in the U.S. over the next decade. Projections are presented by type of good or service delivered (hospital care, physician and clinical services, retail prescription drugs, etc.) and by source of funding for those services (private health insurance, Medicare, Medicaid, out-of-pocket spending, etc.).

Provider of Services File
The POS file contains data on characteristics of hospitals and other types of healthcare facilities, including the name and address of the facility and the type of Medicare services the facility provides, among other information.

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