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CMS releases Medicare payment data for individual providers

The initiative is part of federal efforts to increase transparency in health care.

On April 9, as part of its efforts to increase transparency in health care, the Centers for Medicare and Medicaid Services (CMS) released public data sets on the type of services and procedures furnished by physicians and other health care professionals, including psychologists, in Medicare in 2012.

As the result of a federal court decision in 2013, a previous injunction preventing the release of charge data was lifted. This is the first time the public has had access to data about Medicare billing practices by individual health care professionals nationwide.

The data sets include charges and payment amounts (as well as averages and standard deviations), the coding used, the setting where the service was provided and the provider's national provider identifier (NPI) number and practice location. CMS will not release any personally identifiable information about beneficiaries.

According to the data released by CMS, clinical psychologists had the second highest percent of payment going to the provider (78 percent), as opposed to covering overhead costs. The interactive database from the Washington Post enables users to search the data files by provider.

“Providing consumers with this information will help them make more informed choices about the care they receive,” said Jonathan Blum, Principal Deputy Administrator for CMS, in an April 2 post on the CMS blog. “The initiative announced today… builds on the powerful tools we have from the Affordable Care Act to advance transparency in the health care system.”

In an April 2 letter to the American Medical Association (PDF, 113KB), CMS noted that it was required under the Freedom of Information Act to balance the privacy interests of individual providers and the public interest in the disclosure of such information. In explaining its decision to release the data, CMS said that after weighing the two it concluded that the public interest outweighed individual privacy concerns.