CMS Publishes 2014 Payment Data

May 12, 2016
Rick Gawenda

The Centers for Medicare and Medicaid Services (CMS) has prepared a public data set, the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (Physician and Other Supplier PUF), with information on services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals. Other healthcare professionals include physical and occupational therapists as well as speech-language pathologists in private practice.

The Physician and Other Supplier PUF contains information on utilization, payment (allowed amount and Medicare payment), and submitted charges organized by National Provider Identifier (NPI), Healthcare Common Procedure Coding System (HCPCS) code, and place of service. This PUF is based on information from CMS administrative claims data for Medicare beneficiaries enrolled in the fee-for-service program and covers calendar years 2012 – 2014.

If you are a physical therapist, occupational therapist or speech-language pathologist in private practice, you will want to review your data for the past 3 years as this data is all available to the general public. Two important items to track are the units you billed of each CPT code for calendar years 2012 – 2014 as well as the Medicare average payment for each CPT code billed for the 3 years. I will tell you that your average payment for each CPT code paid in 2014 is less than the average payment for the same CPT paid in 2012, but I’m sure your expenses to run the practice went up during the same time period.

To access the data, click

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This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

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