CMS Updates Physician Payment Information for Value-Driven Health Care (9-27-07)

As part of his commitment to make health care more affordable and accessible, President Bush directed the U.S. Department of Health and Human Services to make cost and quality data available to all Americans.  As a first step in this initiative, on June 1, 2006, Medicare posted information about the payments it made to hospitals in fiscal year 2005 for common elective procedures and other hospital admissions.  Similar postings of Medicare payment data followed during the year for Ambulatory Surgery Centers (ASCs), Hospital Outpatient Departments, and Physician Services.

On June 20, 2007, and August 29, 2007, Medicare updated last year's inpatient hospital and ASC data, respectively.  We are now presenting an update to last year's physician services data, including anesthesia services.  In addition, we are adding a table reflecting physician payment data for many Medicare covered preventive services.  The information is being displayed in the same format as last year, updated with calendar year (CY) 2006 data. 

In early fall, CMS plans to post updated payment information for common hospital outpatient department services.

Below you will find nine zipped Microsoft Excel files and a PDF document.  Please note that some of the files are large so printing them is not recommended.  As a reminder, our objective is to provide the basic information for consumers and others to use and analyze, at their discretion.  Consumers are encouraged to consult with their physicians if they have questions about the procedures/codes contained in any of the files.  The information is provided in Excel format in order to facilitate its use.  Please take note of the footnotes displayed at the end of each table as the footnotes will be helpful in understanding the data contained in the tables.

The first five physician files (the updated files using CY 2006 data and the new preventive services file) are as follows:

"Physician Payments:  72 Commonly Performed Services in a Non-Office Facility Setting" are two files which contain service volumes, charge, and Medicare payment data for physicians' services for a limited set of services, including anesthesia services, rendered in Medicare payment localities. These particular codes/services are directly related to the types of services which may be rendered in an inpatient hospital, outpatient hospital, or ASC, and correlate to most of the procedure codes already posted.

"Physician Payments:  19 Other Commonly Performed Services Provided in an Office Setting" contains similar service, charge, and Medicare payment data, but for physicians' services of high utilization which are commonly performed in a physician's office.

"Physician Payments:  Medicare Preventive Services" also contains similar service, charge, and Medicare payment data, but for many Medicare preventive services rendered by physicians.

The fifth physician file contains a 1-page example of the comprehensive physician data.

The remaining files/document are the same as last year, using CY 2005 data.

Note Regarding Current Procedural Terminology (CPT) Codes Used in the Tables:  CPT only copyright 2006 American Medical Association. All rights reserved. Applicable Federal Acquisition Regulations System (FARS)/Defense Federal Acquisition Regulation Supplement (DFARS) Apply. CPT is a registered trademark of the American Medical Association.

Downloads
2006 Data Physician Payments:  72 Commonly Performed Services in a Non-Office Facility Setting Across all Specialties, CY 2006 Data [Excel/Zip 72KB] Physician Payments:  72 Commonly Performed Services in a Non-Office Facility Setting Across all Specialties – Continued, CY 2006 Data [Excel/Zip 81KB] Physician Payments:  19 Other Commonly Performed Services Provided in an Office Setting, CY 2006 Data [Excel/Zip 42KB] Physician Payments:  Medicare Preventive Services Provided in an Office Setting, CY 2006 Data [Excel/Zip 82KB] Physician Payments Example, CY 2006 Data [Excel/Zip 6KB] 2005 Data Physician Payments:  72 Commonly Performed Services in a Non-Office Facility Setting Across all Specialties, CY 2005 [Excel Zipped, 74KB] Physician Payments:  72 Commonly Performed Services in a Non-Office Facility Setting Across all Specialties - Continued, CY 2005 [Excel Zipped, 85KB] Physician Payments:  19 Other Commonly Performed Services Provided in an Office Setting, CY 2005 [Excel Zipped, 44KB] Physician Payments Example, CY 2005 [Excel Zipped, 12MB] Transparency Initiative Scenarios, CY 2005 [PDF, 16KB]
Related Links Inside CMS
There are no Related Links Inside CMS
Related Links Outside CMS
There are no Related Links Outside CMS

Page Last Modified: 09/27/2007 12:42:31 PM
Help with File Formats and Plug-Ins