Medicare physician payment data release: What you need to know

The Centers for Medicare & Medicaid Services (CMS) has posted the second Part B claims data release on its data website.  CMS released 2012 claims data last spring as part of an effort to increase transparency.  The data released on June 1, 2015 includes Medicare Part B claims data for services provided in 2013.  In addition to a large file containing all 2013 data, CMS has included aggregate files summarizing total payments made to each physician. 

What you need to know
You may be asked about this data.  Patients and the media have access to the data, and a number of articles about the data release have been published in major news outlets including the Wall Street Journal, USA Today and the New York Times.  It is therefore important that you review your data in order to be able to accurately respond to questions.  Physicians who receive media requests regarding the data release may refer the requestor to the AASM for more information (

The data does not separate practice revenue.  Payments made to physicians often include practice expense costs, which are used to cover staff salaries, office expenses, medical equipment and supplies.  It is important to understand that the amount of money a physician receives from Medicare is not personal income for that physician.  This fact should be clarified when speaking to patients about the data release. 

This year, CMS separately identified payments made to physicians for drug costs.  CMS was criticized for its data release in 2014, which did not distinguish payments made for high cost drugs such as chemotherapy.  

CMS plans to continue releasing this data on an annual basis.  The data releases are two years behind, meaning that this time next year we will see a release of 2014 Medicare data.  

2015-06-18T00:00:00+00:00June 18th, 2015|Clinical Resources|