Physicians’ Medicare claims data—including billed charges and total payments—was released Wednesday to the public by the Centers for Medicare & Medicaid Services (CMS). It’s already generating considerable attention. 

Here are three key points physicians need to bear in mind:

  • You can look up your data so you know what reporters and patients are seeing. CMS released 2012 Medicare Part B claims data for individual physicians, including the total amount Medicare paid, the number and type of services provided, the number of unique Medicare patients treated, the average charges submitted and the average amount Medicare paid for those services. The data is posted to the CMS website in 12 separate spreadsheets, which are listed in alphabetical order by last name. These Microsoft Excel files can be downloaded as compressed folders, which also include documents that define the data content of each spreadsheet. You can find your specific data by searching for your National Provider Identifier (NPI) or sorting by your last name.
  • Understand the data limitations to help clear up any confusion or misinterpretations of the data. For instance, even though physicians are primarily concerned about the quality of the care they provide, the data focuses solely on Medicare payment and utilization of services. It doesn’t include explicit information that would help patients assess the quality of their physicians’ care. The AMA has identified the nine key data limitations of which patients, reporters, insurers and others need to be aware. Make sure you’re familiar with these limitations so you can respond to any initial inquiries you might receive about your Medicare claims data.
  • Help is on the way. Although CMS provided the data to some major media outlets in advance, it did not give the AMA access to this information until it was publicly released Wednesday. But the AMA is moving quickly to provide the resources and information you’ll need to navigate the data release and any resulting questions, confusion or misinterpretation you may hear from your patients or reporters.

Additional information about the Medicare claims data release and resources to help navigate this issue will be posted to AMA Wire™ throughout the coming days and weeks.

Featured Stories