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CMS Releases 2013 Part B Claims Data; Separates Part B Drug Costs from Medical Services

This week, CMS released claims data on all Medicare Part B services and administered drugs in 2013. This is the second year CMS has released Medicare claims data for physician services. The new 2013 dataset has information for more than 950,000 distinct healthcare providers who collectively received $72 billion in Medicare payments for services and $17 billion for drugs administered.

Following criticism from ASCRS•ASOA and others in the medical community when 2012 released data included the cost of Part B drugs in the aggregate amounts billed by physicians and was not identified separately, CMS has now published separate totals for each provider, listing the total allowed amount for medical services separate from the allowed amount of Part B drugs administered. The 2013 data also differentiates between what the provider bills Medicare and the payment they actually received. 

Despite these changes, ASCRS•ASOA still contends the dataset released does not accurately reflect the cost of services provided by ophthalmology and provides no context to understand the data presented.

To assist members in understanding the data released and answer questions from patients, ASCRS•ASOA has updated talking points on the data release. CMS has also published a physician look-up tool, a press release, and a data fact sheet.

If you need additional assistance, please contact Ashley McGlone, manager of regulatory affairs, at 703-591-2220.