Medicare Data Reveals Services Docs Provide and Their Pay

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  • April 24, 2014
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Data allowing comparisons of 880,000 healthcare providers who have received $77 billion in Medicare Part B payments in 2012 has been released by the Department of Health & Human Services (HHS).  The new, privacy-protected data allows users to mine how much physicians and other healthcare professionals billed and were paid for more than 6,000 services. The information also allows comparisons by physician, specialty, location, the types of medical service and procedures delivered, Medicare payment, and submitted charges.
HHS said in a fact sheet the data is compiled from claims made under the Medicare Part B fee-for-service program. Users can conduct a wide range of analyses. Physicians and other healthcare professionals determine what they will charge for services and procedures provided to patients. These “charges” are the amount the physician or healthcare professional generally bills for the service or procedure.
“Data transparency is a key aspect of transformation of the health care delivery system,” Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner said. “While there’s more work ahead, this data release will help beneficiaries and consumers better understand how care is delivered through the Medicare program.”
Last May, CMS released hospital charge data allowing consumers to compare what hospitals charge for common inpatient and outpatient services across the country.

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Brad Ericson
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Brad Ericson, MPC, CPC, COSC, is a seasoned healthcare writer and editor. He directed publishing at AAPC for nearly 12 years and worked at Ingenix for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

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