The Medicare Clinical Laboratory Fee Schedule (CLFS) dataset provides raw data reported by any applicable laboratories that reported a volume greater than 10 tests for the data collection period. As described by the Protecting Access to Medicare Act, Applicable Laboratories must report to CMS private payor rates and associated volumes for laboratory tests on the Clinical Laboratory Fee Schedule.

The Nursing Home Affiliated Entity Performance Measures dataset provides select quality and performance measures from Care Compare for groups of nursing homes that share common individual or organizational owners, officers, or entities with operational/managerial control. The data include measures such as average health and staffing star ratings, staffing measures, average quality star ratings, select enforcement remedies, claims-based and Minimum Data Set (MDS) measures, average Skilled Nursing Facility Quality Reporting Program (SNF QRP) metrics, and COVID-19 vaccination rates.

The Hospital Provider Cost Report dataset provides select measures from the hospital annual cost report. This data includes provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data organized by CMS Certification Number.

The Payroll Based Journal (PBJ) Nurse Staffing and Non-Nurse Staffing datasets provide information submitted by nursing homes including rehabilitation services on a quarterly basis. The View Data link above includes the hours staff are paid to work each day, for each facility, aggregated by staff reporting category.  Examples of reporting categories include Director of Nursing, Administrative Registered Nurses, Registered Nursing, Administrative Licensed Practice Nurses, Licensed Practice Nurses, Certified Nurse Aides, Certified Medication Aides, and Nurse Aides in Training. There are also other non-nurse staff categories provided in the data such as Respiratory Therapist, Occupational Therapist, and Social Worker. The datasets also include a facility’s daily census calculated using the Minimum Data Set (MDS) submission.

The Payroll Based Journal (PBJ) Employee Detail Nursing Home Staffing datasets and technical information have been moved to a new location.

Note: This full dataset contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.

The Skilled Nursing Facility (SNF) All Owners dataset provides information on all owners of SNFs currently enrolled in Medicare. This data includes ownership information such as ownership name, ownership type, ownership address and ownership effective date.

The Medicare Inpatient Hospitals by Provider and Service dataset provides information on inpatient discharges for Original Medicare Part A beneficiaries by IPPS hospitals. It includes information on the use, payment, and hospital charges for more than 3,000 U.S. hospitals that received IPPS payments. The data are organized by hospital and Medicare Severity Diagnosis Related Group (DRG).

 

Hospitals determine what they will charge for items and services provided to patients, and these charges are the amount the hospital bills for an item or service. The Total Payment Amount includes the DRG amount, claim per diem amount, beneficiary primary payer claim payment amount, beneficiary Part A (Hospital Insurance) coinsurance amount, beneficiary deductible amount, beneficiary blood deductible amount and diagnosis related group outlier amount.

The Hospital Price Transparency Enforcement Activities and Outcomes dataset contains information related to enforcement actions taken by CMS following a compliance review of a hospital's obligation to establish, update and make public a list of the hospital’s standard charges for items and services provided by the hospital, in accordance with regulation (45 CFR 180). This data set includes the name of each hospital or hospital location, the hospital or hospital location address, the outcome or action following a CMS compliance review and the date of the outcome or action taken.

The Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator 11 (PSI-11) Measure Rates dataset provides information on provider-level measure rates regarding one preventable complication (postoperative respiratory failure) for Medicare fee-for-service discharges. The PSI-11 measure data is solely reported for providers’ information and quality improvement purposes and are not a part of the Deficit Reduction Act (DRA) Hospital-Acquired Condition (HAC) Payment Provision or HAC Reduction Program.

The Medicare Advantage Geographic Variation National & State dataset provides information on demographic characteristics and service utilization for hospital inpatient, skilled nursing facility services, outpatient, DME, and professional services between 2016-2021 for Medicare Advantage beneficiaries at the national and state levels.

Please be advised that as of Q4 2023 there is a new Provider of Service file (POS) that contains the provider and certification details for Home Health Agencies (HHAs), Hospices, and Ambulatory Surgical Centers (ASCs). Data contained in this file are extracted from the Internet Quality Improvement and Evaluation System (iQIES) environment and will be updated quarterly along with the other two POS files.

 

The Provider of Services File - Hospital & Non-Hospital Facilities data provide critical resources for other federal regulator requirements as well as supports the ongoing quality & research efforts sponsored by CMS. In this file you will find provider certification, termination, accreditation, ownership, name, location and other characteristics organized by CMS Certification Number.