data.cms.gov
Physician/Supplier Procedure Summary
The Physician/Supplier Procedure Summary (PSPS) data provides a summary of calendar year Medicare Part B carrier and durable medical equipment fee-for-service (FFS) claims.
Freshness
- Last posted
- Period covered
- Jan 1, 2025 to Dec 31, 2025
- Update frequency
- Annually
Dates as CMS lists them in its catalog.
Columns 18
| Column | What it means | Type |
|---|---|---|
HCPCS CodeHCPCS_CD | The Health Care Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. The codes are divided into three levels, or groups as described below: Level I Codes and descriptors copyrighted by the American Medical Association's Current Procedural Terminology, Fourth Edition (CPT-4). These are 5 position numeric codes representing physician and nonphysician services. **** Note: **** CPT-4 codes including both long and short descriptions shall be used in accordance with the CMS/AMA agreement. Any other use violates the AMA copyright. Level II Includes codes and descriptors copyrighted by the American Dental Association's Current Dental Terminology, Third Edition (CDT-3). These are 5 position alpha-numeric codes comprising the D series. All other level II codes and descriptors are approved and maintained jointly by the alpha-numeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). These are 5 position alpha-numeric codes representing primarily items and nonphysician services that are not represented in the level I codes. Level III Codes and descriptors developed by Medicare carriers for use at the local (carrier) level. These are 5 position alpha-numeric codes in the W, X, Y or Z series representing physician and nonphysician services that are not represented in the level I or level II codes. | string |
HCPCS Initial Modifier CodeHCPCS_INITIAL_MODIFIER_CD | A first modifier to the HCPCS procedure code to enable a more specific procedure identification for the line item service on the noninstitutional claim. | string |
Provider Specialty CodePROVIDER_SPEC_CD | CMS specialty code used for pricing the line item service on the noninstitutional claim. | string |
Carrier NumberCARRIER_NUM | The identification number assigned by CMS to a carrier authorized to process claims from a physician or supplier. | string |
Pricing Locality CodePRICING_LOCALITY_CD | Code denoting the carrier-specific locality used for pricing the service for this line item on the carrier claim (non-DMERC). For DMERCs, this field contains the beneficiary SSA State Code. | string |
Type of Service CodeTYPE_OF_SERVICE_CD | Code indicating the type of service, as defined in the CMS Medicare Carrier Manual, for this line item on the non-institutional claim. | number |
Place of Service CodePLACE_OF_SERVICE_CD | The code indicating the place of service, as defined in the Medicare Carrier Manual, for this line item on the noninstitutional claim. | string |
HCPCS Second Modifier CodeHCPCS_SECOND_MODIFIER_CD | A second modifier to the HCPCS procedure code to make it more specific than the first modifier code to identify the line item procedures for this claim. | string |
Physician/Supplier Procedure Summary (PSPS) Submitted Service CountPSPS_SUBMITTED_SERVICE_CNT | The count of the total number of submitted services. Format: 9999999999.999 | number |
Physician/Supplier Procedure Summary (PSPS) Submitted Charge AmountPSPS_SUBMITTED_CHARGE_AMT | The amount of charges submitted by the provider to Medicare. Format: +999999999.99 | number |
Physician/Supplier Procedure Summary (PSPS) Allowed Charge AmountPSPS_ALLOWED_CHARGE_AMT | The amount that is approved (allowed) for Medicare. Format: +999999999.99 | number |
Physician/Supplier Procedure Summary (PSPS) Denied Services CountPSPS_DENIED_SERVICES_CNT | The count of the number of submitted services that are denied by Medicare. Format: 9999999999.999 | number |
Physician/Supplier Procedure Summary (PSPS) Denied Charge AmountPSPS_DENIED_CHARGE_AMT | The amount of submitted charges for which Medicare payment was denied. Format: +999999999.99 | number |
Physician/Supplier Procedure Summary (PSPS) Assigned Services CountPSPS_ASSIGNED_SERVICES_CNT | The count of the number of services from providers accepting Medicare assignment. Format: 9999999999.999 | number |
Physician/Supplier Procedure Summary (PSPS) NCH Payment AmountPSPS_NCH_PAYMENT_AMT | The amount of payment made from the trust fund (after deductible and coinsurance amounts have been paid). Format: +999999999.99 | number |
Physician/Supplier Procedure Summary (PSPS) HCPCS ASC Indicator CodePSPS_HCPCS_ASC_IND_CD | A Y/N code used to indicate whether the procedure is approved to be performed in an Ambulatory Surgical Center (ASC). | string |
Physician Supplier Procedure Summary (PSPS) Error Indicator CodePSPS_ERROR_IND_CD | The code used to indicate combinations of errors on key fields. | number |
HCPCS Berenson-Eggers Type of Service Code (BETOS)HCPCS_BETOS_CD | This field is valid beginning with 2003 data. The Berenson-Eggers Type of Service (BETOS) for the procedure code based on generally agreed upon clinically meaningful groupings of procedures and services. | string |
No column matches that filter.
At a glance
- Catalog
- data.cms.gov
- Publisher
- Office of Enterprise Data and Analytics (OEDA)
- Rows
- 14,474,585
- Columns
- 18
- State column
- None found
API
Free, no key needed. This request returns the first 10 rows as JSON:
https://data.cms.gov/data-api/v1/dataset/164fc736-4179-4100-9f79-592b69e41975/data?size=10
Versions 16
The newest version is the one linked above. Older releases stay on the official site.
- 2025-01-02posted Aug 11, 2026
- 2024-01-01posted Jan 9, 2026
- 2023-01-01posted Aug 21, 2024
- 2022-01-01posted Aug 31, 2023
- 2021-01-01posted May 23, 2024
- 2020-12-31posted May 31, 2022
- 2019-12-31posted Feb 5, 2021
- 2018-03-16posted Nov 9, 2020
Show 8 older versions
- 2017-12-31posted Nov 9, 2020
- 2016-12-31posted Nov 9, 2020
- 2015-12-31posted Nov 9, 2020
- 2014-12-31posted Nov 9, 2020
- 2013-12-31posted Nov 9, 2020
- 2012-12-31posted Nov 9, 2020
- 2011-11-09posted Nov 9, 2020
- 2010-12-31posted Nov 10, 2020
CMS's description
The Physician/Supplier Procedure Summary (PSPS) data provides a summary of calendar year Medicare Part B carrier and durable medical equipment fee-for-service (FFS) claims. The file is organized by carrier, pricing locality, Healthcare Common Procedure Coding System (HCPCS) code, HCPCS modifier, provider specialty, type of service, and place of service. The summarized fields are total submitted services and charges, total allowed services and charges, total denied services and charges, and total payment amounts. This dataset is produced annually and is typically available in July (i.e., data for CY2015 is usually available in July 2016).
Methodology and other documents from CMS:
The summary at the top is the first sentence of this description. Record id cms:164fc736-4179-4100-9f79-592b69e41975. This record as JSON.