Medicare Compliance & Reimbursement

If you want to find utilization data on the number of procedures clinicians and physicians have done, that information will now be available to search on Care Compare for the first time.

Details: On Jan. 18, the Centers for Medicare & Medicaid Services (CMS) announced the procedure volume data update to the Compare tool on the doctors and clinicians profile page.

“The procedures initially added to profile pages were performed by doctors and clinicians for Original Medicare and Medicare Advantage patients in the last 12 months, after allowing a three-month claim processing period,” CMS says on its website. “For example, claims for dates of service occurring between June 1, 2022 through June 30, 2023 that were processed by September 30, 2023,” the agency adds.

Heads up: The new utilization information is a subset of the “Medicare Physician & Other Practitioners – by Provider and Service” dataset, CMS explains. This first release offers insight on the volume of these specific 12 procedures: hip replacement; knee replacement; spinal fusion; cataract surgery; colonoscopy; hernia repair – groin (open); hernia repair (minimally invasive); mastectomy; coronary artery bypass graft (CABG); pacemaker insertion or repair; coronary angioplasty and stenting; and prostate resection.

Review the CMS update at www.cms.gov/medicare/quality/ physician-compare-initiative and find the Care Compare site at www.medicare.gov/care-compare/.