CMS Updates Provider Payment and Utilization Public Use Files with 2019 Data

September 3, 2021
Policy Snapshot

The Centers for Medicare & Medicaid Services (CMS) released an update to the Medicare Provider Payment and Utilization Public Use Files with data from 2019. These data files summarize the utilization and payments for procedures, services, and prescription drugs provided to Medicare beneficiaries by specific inpatient and outpatient hospitals, physicians, other practitioners, and suppliers.

The 2019 data and all previous years of the provider payment and utilization data are available from the links described below.

Medicare Provider Utilization and Payment Data: Physician and Other Supplier 

  • The Physician and Other Supplier Public Use File (Physician and Other Supplier PUF) provides information on services and procedures provided to Medicare beneficiaries by physicians and other health-care professionals.
  • Detailed Data (By Provider and HCPCS)
  • Provider Summary (By Provider)
  • Procedure Summary (By HCPCS and Geography)

 

‘Medicare Provider Utilization and Payment Data: Inpatient 

  • The Inpatient Utilization and Payment Public Use File (Inpatient PUF) provides information on inpatient discharges for Medicare fee-for-service beneficiaries.
  • Detailed Data (By Provider and MS-DRG)
  • MS-DRG Summary (By MS-DRG and Geography)

 

Medicare Provider Utilization and Payment Data: Outpatient 

  • The Outpatient Utilization and Payment Public Use File (Outpatient PUF) presents information on common outpatient services provided to Medicare fee-for-service beneficiaries.
  • Detailed Data (by Provider and APC)
  • By Geography and Service Summary (By APC, HCPCS and Geography)

 

Medicare Provider Utilization and Payment Data: Part D Prescriber 

  • The Part D Prescriber PUF provides information on prescription drugs prescribed by individual physicians and other health-care providers and paid for under the Medicare Part D Prescription Drug Program.
  • Detailed Data (By Provider and Drug Brand/Generic Name)
  • Provider Summary (By Provider)
  • Drug Summary (By Drug Brand/Generic Name and Geography)

 

Medicare Provider Utilization and Payment Data: Referring Durable Medical Equipment, Prosthetics, Orthotics, and Supplies 

  • The Referring Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) PUF (Referring Provider DMEPOS PUF) presents information on DMEPOS products and services provided to Medicare beneficiaries ordered by physicians and other health-care professionals.  
  • Detailed Data (By Referring Provider and HCPCS)
  • Provider Summary (By Referring Provider)
  • Product Summary (By HCPCS and Geography)

 

Inquiries regarding this data can be sent to MedicareProviderData@cms.hhs.gov.

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