CMS Physician Compare Data dictionary - onetomapanalytics/Meta_Data GitHub Wiki

CMS - Physician compare Data dictionary

Doctors & Clinicians National Downloadable File: Performance Year 2018

The Doctors & Clinicians national downloadable file is organized at the individual eligible clinician level; each line is unique at the clinician/enrollment record/group/address level. Clinicians with multiple Medicare enrollment records and/or single enrollments linking to multiple practice locations are listed on multiple lines.

Variable Name	Variable Label	Description	Length	Values
Professional Identification
NPI	NPI	Unique clinician ID assigned by NPPES	10	digits
Ind_PAC_ID	PAC ID	Unique individual clinician ID assigned by PECOS	10	digits
Ind_enrl_ID	Clinician Enrollment ID	Unique ID for the clinician enrollment that is the source for the data in the observation	15	digits
lst_nm	Last Name	Individual clinician last name	35	digits
frst_nm	First Name	Individual clinician first name	25	string
mid_nm	Middle Name	Individual clinician middle name	25	string
suff	Suffix	Individual clinician suffix	10	string
gndr	Gender	Individual clinician gender	1	M/F/U
Medical Credentials
Cred	Credential	Medical credential such as MD; DO; DPM; etc.	3	string
Med_sch	Medical school name	Individual clinician’s medical school	100	string
Grd_yr	Graduation year	Individual clinician’s medical school graduation year	4	digits
Pri_spec	Primary specialty	Primary medical specialty reported by the individual clinician in the selected enrollment	60	string
Sec_spec_1	Secondary specialty 1	First secondary medical specialty reported by the individual clinician in the selected enrollment	60	string
Sec_spec_2	Secondary specialty 2	Second secondary medical specialty reported by the individual clinician in the selected enrollment	60	string
Sec_spec_3	Secondary specialty 3	Third secondary medical specialty reported by the individual clinician in the selected enrollment	60	string
Sec_spec_4	Secondary specialty 4	Fourth secondary medical specialty reported by the individual clinician in the selected enrollment	60	string
Sec_spec_all	All secondary specialties	All secondary medical specialty reported by the individual clinician in the selected enrollment	200	string
Medical Practice
Org_nm	Organization legal name	Legal name of the group that the individual clinician works with – will be blank if the address is not linked to a group	70	string
Org_PAC_ID	Group PAC ID	Unique group ID assigned by PECOS to the group that the individual clinician works with- will be blank if the address is not linked to a group	10	string
num_org_mem	Number of Group Members	Total number of individual clinicians affiliated with the group based on Group Practice PAC ID	8	numeric
adr_ln_1	Line 1 Street Address	Group or individual's line 1 address	55	string
adr_ln_2	Line 2 Street Address	Group or individual's line 2 address	55	string
ln_2_sprs	Marker of address line 2 suppression	Marker that address as reported may be incomplete	1	Y/blank
cty	City	Group or individual's city	30	string
st	State	Group or individual's state	2	string
zip	Zip code	Group or individual's zip code (9 digits when available)	15	digits
phn_numbr	Phone Number	Phone number is listed only when there is a single phone number available for the address	20	string
hosp_afl_1	Hospital affiliation CCN 1	Medicare CCN of hospital where individual clinician provides service	6	digits
hosp_afl_lbn_1	Hospital affiliation LBN 1	Legal business name of hospital where individual clinician provides service	200	string
hosp_afl_2	Hospital affiliation CCN 2	Medicare CCN of hospital where individual clinician provides service	6	digits
hosp_afl_lbn_2	Hospital affiliation LBN 2	Legal business name of hospital where individual clinician provides service	200	string
hosp_afl_3	Hospital affiliation CCN 3	Medicare CCN of hospital where individual clinician provides service	6	digits
hosp_afl_lbn_3	Hospital affiliation LBN 3	Legal business name of hospital where individual clinician provides service	200	string
hosp_afl_4	Hospital affiliation CCN 4	Medicare CCN of hospital where individual clinician provides service	6	digits
hosp_afl_lbn_4 Hospital affiliation LBN 4 Legal business name of hospital where individual clinician provides service	200	string
hosp_afl_5	Hospital affiliation CCN 5	Medicare CCN of hospital where individual clinician provides service	6	digits
hosp_afl_lbn_5	Hospital affiliation LBN 5	Legal business name of hospital where individual clinician provides service	200	string
Medicare Assignment
assgn	Clinician accepts Medicare Assignment	Y = Clinician accepts Medicare approved amount as payment in full; M = Clinician may accept Medicare Assignment	1	Y/M

Doctors & Clinicians Quality Payment Program PY 2018 Clinician Public Reporting: Measures and Activities

PY 2018 Merit-based Incentive Payment System (MIPS) performance information reported by clinicians

Measures and activities are listed in the downloadable file using technical titles. To make measures more understandable to users, measures and activities on Medicare Care Compare profile pages are displayed in plain language. A crosswalk showing both technical measure titles and plain language measure titles and descriptions can be found on the Physician Compare Initiative page. More clinician performance information is reported in the Provider Data Catalog (PDC) than on the Care Compare profile pages (see Additional Information).

Variable Name	Variable Label	Description	Length	Values
NPI	NPI	Unique clinician ID assigned by NPPES	10	digits
Ind_PAC_ID	PAC ID	Unique individual clinician ID assigned by PECOS	10	digits/blank
lst_nm	Last Name	Individual clinician last name	35	string
frst_nm	First Name	Individual clinician first name	25	string
APM_affl_1	APM Affiliation 1	Name of Alternative Payment Model (APM) with whom the individual eligible clinician participates	250	string
APM_affl_2	APM Affiliation 2	Name of Alternative Payment Model (APM) with whom the individual eligible clinician participates	250	string
APM_affl_3	APM Affiliation 3	Name of Alternative Payment Model (APM) with whom the individual eligible clinician participates	250	string
APM_affl_4	APM Affiliation 4	Name of Alternative Payment Model (APM) with whom the individual eligible clinician participates	250	string
measure_cd	Measure Code	Components of measure code: [program][reporting entity][status][measure number][stratum] where program is defined as MIPS; QCDR; PI; or IA; reporting entity is indicated as EC for individual eligible clinician; measure number denotes the measure number or string identifier; status is only applicable for PI measures and indicates whether the measure is from the transition measure set; and stratum indicates whether it is an overall rate or a single stratum	40	string
measure_title	Measure or Attestation Title	Measure or attestation title	250	string
invs_msr	Inverse Measure Indicator for inverse measures	1	Y/N
attestation_value	Attestation Value	Attestation value	1	Y/blank
prf_rate	Measure Performance Rate	Measure performance rate	3	numeric/blank
patient_count	Denominator Count	Number of patients included in the measure denominator	8	numeric/blank
star_value	Star Value	Star rating; assigned based on performance at the measure and collection type level	3	numeric/blank
five_star_benchmark	Five Star Benchmark	The established ABC™ benchmark used to assign a five-star rating for a given measure and collection type	3	numeric/blank
collection_type	Collection Type	Collection types are defined as ATT for Web Attestation; CLM for Claims; EHR for Electronic Health Record; QCDR for Qualified Clinical Data Registry; and REG for Qualified Registry. Note: Collection type is not published for PI and IA attestations	4	string
live_site_ind	Reported on DAC profiles	Indicator for whether or not the measure/attestation is reported on Care Compare profile pages (i.e. measures with an N value are only available in the PDC)	1	Y/N

Doctors & Clinicians Quality Payment Program PY 2018 Clinician Public Reporting: Overall MIPS Performance

PY 2018 Merit-based Incentive Payment System (MIPS) Overall Clinician Performance

Variable Name	Variable Label	Description	Length	Values
NPI	NPI	Unique clinician ID assigned by NPPES	10	digits
Org_PAC_ID	Organization PAC ID	Unique group ID assigned by PECOS to the group this individual participated in	10	digits
lst_nm	Last Name	Individual clinician last name	35	string
frst_nm	First Name	Individual clinician first name	25	string
source	Source of scores	Method by which clinician achieved scores (individual; group; virtual group; apm; or neutral adjustment); if the source is apm this indicates that the MIPS APM scoring standard was applied for this set of scores	20	string
quality_category_score	Quality category score	Quality category score	12	string
PI_category_score	PI category score	PI category score. A score above 0 indicates that the clinician successfully reported the PI category; A score of 50 or above indicates that the clinician achieved the base score for the PI category	12	string
Cost_category_score	cost category score	Cost category score	12	string
IA_category_score	IA category score	IA category score	12	string
final_MIPS_score	Final MIPS score	Final MIPS score	8	numeric

Doctors & Clinicians Quality Payment Program PY 2018 Group Public Reporting: Measures

PY 2018 Merit-based Incentive Payment System (MIPS) performance information reported by groups

Variable Name	Variable Label	Description	Length	Values
org_nm	Organization legal name or 'doing business as' name	Name of the group as it appears on Care Compare: Doctors & Clinicians	70	string
org_PAC_ID	Group PAC ID	Unique group ID assigned by PECOS to the group	10	digits
ST	State	State with all or majority of the group’s locations	2	string
ACO_ID_1	ACO ID 1	ACO ID used on Care Compare	5	string
ACO_nm_1	ACO Name 1	Name of the ACO; as it appears on Care Compare	70	string
ACO_ID_2	ACO ID 2	ACO ID used on Care Compare	5	string
ACO_nm_2	ACO Name 2	Name of the ACO; as it appears on Care Compare	70	string
measure_cd	Measure Code	Components of measure code:[program][reporting entity][status][measure number][stratum] where program is defined as MIPS; QCDR; PI; or IA; reporting entity is indicated as GRP for group; measure number denotes the measure number or string identifier; status is only applicable for PI measures and indicates whether the measure is from the transition measure set; and stratum indicates whether it is an overall rate or a single stratum	40	string
measure_title	Measure or Attestation Title	Measure or attestation title	250	string
invs_msr	Inverse Measure	Indicator for inverse measures	1	Y/N
attestation_value	Attestation Value	Attestation value	1	Y/blank
prf_rate	Measure Performance Rate	Measure performance rate	3	numeric/blank
patient_count	Denominator count	Number of patients included in the measure denominator	8	numeric/blank
star_value	Star Value	Star rating; assigned based on performance at the measure and collection type level	3	numeric/blank
five_star_benchmark	Five Star Benchmark	The established ABC™ benchmark used to assign a five-star rating for a given measure and collection type	3	numeric/blank
collection_type	Collection Type	Collection types are defined as ATT for Web Attestation; EHR for Electronic Health Record; QCDR for Qualified Clinical Data Registry; REG for Qualified Registry; WI for CMS Web Interface. Note: Collection type is not published for PI and IA attestations	4	string
live_site_ind	Reported on PC Live Site	Indicator for whether or not the measure is reported on Care Compare profile pages (i.e. measures with an N value are only available in the PDC)	1	Y/N

Doctors & Clinicians Quality Payment Program PY 2018 Group Public Reporting: Patient Experience

PY 2018 Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS measures reported by groups

Variable Name	Variable Label	Description	Length	Values
org_nm	Organization legal name or 'doing business as' name	Name of the group as it appears on Care Compare: Doctors & Clinicians profile pages	70	string
org_PAC_ID	Group PAC ID	Unique group ID assigned by PECOS to the group	10	string
ST	State	State with all or majority of the group’s locations	2	string
measure_cd	Measure Code	Components of measure code:[program][reporting entity][measure number] where program is defined as CAHPS; reporting entity is indicated as GRP for group; and measure number denotes the CAHPS measure number	40	string
measure_title	Measure Title	CAHPS measure title	250	string
prf_rate	Measure Performance Rate	Measure performance rate	3	Numeric/blank
patient_count	Denominator count	Number of patients included in the measure denominator	8	Numeric/blank
FN	Footnote	1- Data are suppressed due to insufficient sample size or low reliability	1	1/blank

Doctors & Clinicians 2017 Clinician Utilization Data

Variable Name	Variable Label	Description	Length	Values
NPI	NPI	Unique clinician ID assigned by NPPES	10	digits
Ind_PAC_ID	PAC ID	Unique individual clinician ID assigned by PECOS	10	digits
lst_nm	Last Name	Individual clinician last name	35	string
frst_nm	First Name	Individual clinician first name	25	string
spec	Specialty	Primary medical specialty reported by the individual clinician in the selected PECOS enrollment	35	string
prac_st	Practice State	Individual clinician’s state of practice	2	string
hcpcs_code	HCPCS code	Healthcare Common Procedure Coding System (HCPCS) procedural code billed by the individual clinician	5	string
hcpcs_description	Code Description	Description of the HCPCS code for the specific medical service furnished by the individual clinician. HCPCS descriptions associated with CPT codes are consumer friendly descriptions provided by the AMA. CPT Consumer Friendly Descriptors are lay synonyms for CPT descriptors that are intended to help healthcare consumers who are not medical professionals understand clinical procedures on bills and patient portals. CPT Consumer Friendly Descriptors should not be used for clinical coding or documentation. All other descriptions are CMS Level II descriptions provided in long form. Due to variable length restrictions; the CMS Level II descriptions have been truncated to 256 bytes. As a result; the same HCPCS description can be associated with more than one HCPCS code. For complete CMS Level II descriptions; visit https://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.html	258	string
line_srvc_cnt	Service Count	Frequency of individual clinician's performance of the associated HCPCS code within the specified calendar year	8	numeric
bene_cnt	Beneficiary Count	The number of eligible beneficiaries that received the service or procedure identified by the individual clinician's HCPCS code	8	numeric

CMS - Physician compare Data dictionary