Physician Performance Module | CarePrecise
Healthcare provider data

Physician Performance Module (PPM)

U.S. Physicians' HCPCS/CPT procedures & durable medical equipment (DME) orders.

 

The Physician Performance Module (PPM) is an extract of the Authoritative Physician Database, containing the HCPCS/CPT procedures and office visits performed by physicians for their Medicare patients, as well as their DME and POS (prosthetics, orthotics, and supply) orders. Physician names and addresses are not included; to link the PPM data to practice and physician contact data, license information, and more, the PPM integrates with the CarePrecise Master Bundle using the NPI number as the relational key.

 

Because the source data for the PPM is collected, processed and released once per year by the Centers for Medicare and Medicaid Services, it is offered as a single purchase only, with the exception of redistribution licensees, who will receive it upon each update through the term of the license.

 

Used in conjunction with the Master Bundle, the PPM offers insight into physicians' medical procedure volumes and charges, and can be used to roll up medical procedure volumes per practice location. Adding the Authoritative Hospital Database, it becomes possible to view medical services volumes within a health system/hospital macrocosm.

 

Available for immediate download: $349

 

Product Details

CarePrecise data sets connect together to form a unified provider database. Add the Master Bundle data set to the Physician Performance Module, it is possible to see all of the providers who practice together, including physicians, nutritionists, RNs, and all other taxonomies of healthcare providers, as well as their organizations and employers, using CarePrecise's exclusive CoLoCode co-located provider identifier. Medical procedures and orders and charges by individual physicians can this be rolled up to particular practice locations.

 

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Printer-friendly version of the PPM database fields Click for a printer-friendly version of the fields list...

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Data Table/File Name Field Name Description Data Type Size

DB FILE: Procedures.mdb

APD_PhysicianProcedure

Physician procedure volumes and counts of services and patients served, from CMS-collected HCPCS reporting.

Also included is a CSV version of this table.

 NPI National Provider Identifier of clinician Text 10
HCPCS_Code Healthcare Common Procedure Coding System (HCPCS) procedural code billed by the clinician. HCPCS procedures performed by physician are listed. HCPCS Level I codes are same as CPT codes. Text 24
HCPCSDrugIndic HCPCS Drug Indicator. Text 255
PlaceOfService Place where service was rendered.    
ServiceCount Frequency of individual clinician's performance of the associated HCPCS code within the calendar year. Text 10
BeneficiaryCount The number of beneficiaries that received the service or procedure identified by the HCPCS code. Text 10
AvgMedicarePayment Average Medicare Payment Amount. Double  
AvgSubmittedCharge Average Submitted Charge Amount. Double  
MeasureYear The most recent year of procedure data reported by CMS. Text 4

APD_ProcedureDescriptions

Physician procedure volumes. Ongoing extraction from CMS-collected HCPCS reporting. Abbreviated descriptions. Click to view Procedure Codes...

Also included is a CSV version of this table.

 

 HCPCS_Code Healthcare Common Procedure Coding System (HCPCS) procedural code billed by the clinician Text 24
ProcedureDescription Lay-friendly description of procedure associated with HCPS code Long Text Long Text

DB FILE: DMEPOS.mdb

APD_PhysicianDMEPOS

Physician Durable Medical Equipment (DME) orders and Prosthetics, Orthotics and Supplies (POS) orders, listing DMEPOS ordered by physician, and counts of services, claims, suppliers and patients served, from CMS-collected HCPCS reporting.

Also included is a CSV version of this table.

 NPI National Provider Identifier of clinician Text 10
HCPCS_Code Healthcare Common Procedure Coding System code for the specific product or service furnished by the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) supplier. Level II codes. Text 24
Rental Identifies whether the DMEPOS product/service submitted on the supplier's claim is rental or non-rental - Y = rental, N = non-rental Text 1
Suppliers Number of suppliers rendering DMEPOS products/services ordered by the referring provider Text 12
Beneficiaries Number of beneficiaries associated with the supplier DMEPOS products/services ordered by the referring provider. Beneficiary counts fewer than 11 have been suppressed to protect the privacy of Medicare beneficiaries. Text 12
Claims Number of DMEPOS claims submitted by the supplier, reflecting products/services ordered by the referring provider. Aggregated records based on claims fewer than 11 are not included. Text 12
Services Number of DMEPOS products/services rendered by the supplier Text 12
AvgSubmittedCharge Average of the charges that suppliers submit for DMEPOS products/services. Total submitted charges can be calculated by multiplying the AvgSubmittedCharge by the Services. Double  
AvgMedicareAllowAmount Average Medicare allowed amounts for the DMEPOS product/service rendered by suppliers. Allowed: amount Medicare pays, deductible and coinsurance the beneficiary pays, amounts that a third party pays. Total Medicare allowed amounts can be calculated by multiplying the AvgMedicareAllowAmount by the Services. Double  
AvgMedicarePaymentAmount Average amount Medicare paid suppliers after deductible and coinsurance amounts have been deducted for the line item DMEPOS product/service. Total Medicare payment amounts can be calculated by multiplying the AvgMedicarePaymentAmount by the Services. Double  
AvgMedicareStandardAmount Average amount Medicare paid suppliers after deductible and coinsurance amounts have been deducted for the line item DMEPOS product/service. Total Medicare payment amounts can be calculated by multiplying the AvgMedicarePaymentAmount by the Services. Double  
MeasureYear Year of care the data reflects (most recent CMS data release on this physician) Text 4
Classification BETOS Classification Group. High level grouping of the BETOS Classifications into three groups including Durable Medical Equipment, Prosthetic and Orthotic Devices, and Drugs and Nutritional Products. Text 255

tAPD_DMEPOSDescriptions

Physician procedure volumes. Ongoing extraction from CMS-collected HCPCS reporting. Abbreviated descriptions. Click to view Procedure Codes...

Also included is a CSV version of this table.

 HCPCS_Code Healthcare Common Procedure Coding System code for the specific product or service furnished by the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) supplier Text 24
DMEPOS Description Lay-friendly description of procedure associated with the DMEPOS HCPCS code Long Text 255

 

DELIVERY

Immediate download from our online store. Optional shipping via mail on a DVD disk or thumb drive is also available. Optional secure, automation-friendly FTP push delivery is available for subscribers.

 

FILE FORMATS

The downloaded zip file contains the PPM in two file formats, each containing identical data:

  • Comma Separated Values (.csv); normalized relational tables; may be used in Excel or imported into any spreadsheet or database software on Windows, Mac or Linux system.
  • Microsoft Access 2003/2007/2010/2013 (.mdb); normalized relational tables, with example queries.

 

SUPPORT

The Single Download option includes 30 days of free Telephone Technical Support. Subscription options come with 90 days of free Telephone Technical Support. Ongoing technical support via email. See support details.

 

LICENSING

CarePrecise data is licensed for use by the purchaser and may not be redistributed, placed in a data lake, or used to produce a commercial derivative product without an additional license agreement. Special licensing is available. Unless a redistribution or multi-user license is obtained separately, the standard End User License Agreement permits the licensee to use the data in any way desired as long as it is within and for the buyer's own organization and is used by only one user at a time (may not be installed on multiple computers for use by multiple simultaneous users). Alternative licensing options are available for uses that involve distribution of the data or use of the data by more than one user and/or for public viewing, and are purchased separately. For information on licensing CarePrecise data for use in your web applications, products or services, phone 1 (877) 782-2294 extension 9.

 

MORE INFORMATION

Contact CarePrecise Sales at (877) 782-2294, sales@careprecise.com

 

 

Not all records are populated with all data. See important information.

Subscription plans include the listed release schedule for the listed time period, with releases approximately monthly or approximately quarterly as indicated. Each release is based on the most recent dissemination from the data sources currently available at the time of the release.

* Not all records are populated with all data. See Data Contents, above.

** Subscription plans include the listed release schedule for the listed time period, with releases approximately monthly or approximately quarterly as indicated. Each release is based on the most recent dissemination from the data sources currently available at the time of the release.

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