| Type: | Package |
| Title: | Calculate Medicare Reimbursement |
| Version: | 0.1.0 |
| Description: | Uses the 'CMS' application programming interface https://dnav.cms.gov/api/healthdata to provide users databases containing yearly Medicare reimbursement rates in the United States. Data can be acquired for the entire United States or only for specific localities. Currently, support is only provided for the Medicare Physician Fee Schedule, but support will be expanded for other 'CMS' databases in future versions. |
| License: | GPL-3 |
| Encoding: | UTF-8 |
| LazyData: | true |
| Depends: | R (≥ 2.10) |
| Imports: | assertthat (≥ 0.2), dplyr (≥ 0.8), magrittr (≥ 1.5), readr (≥ 1.3), rlang (≥ 0.4), rvest (≥ 0.3), utils (≥ 3.6), xml2 (≥ 1.3) |
| URL: | https://github.com/subramv/cms |
| BugReports: | https://github.com/subramv/cms/issues |
| RoxygenNote: | 7.1.0 |
| Suggests: | knitr, rmarkdown, testthat |
| VignetteBuilder: | knitr |
| NeedsCompilation: | no |
| Packaged: | 2020-09-02 16:59:14 UTC; Vigu |
| Author: | Vigneshwar Subramanian [aut, cre], Raoul Wadhwa [aut], Milind Desai [ctb] |
| Maintainer: | Vigneshwar Subramanian <vs347@cornell.edu> |
| Repository: | CRAN |
| Date/Publication: | 2020-09-10 09:20:09 UTC |
cms: Tools for Calculating CMS Medicare Reimbursement
Description
Uses the CMS API to provide useRs databases containing yearly Medicare reimbursement rates in the United States. Data can be acquired for the entire United States or only for specific localities. Currently, support is only provided for the Medicare Physician Fee Schedule (MPFS), but support will be expanded for other CMS databases in future versions.
Access Medicare Physician Fee Schedule
Description
Use the CMS API to download the MPFS database for any year between 2014 and 2020, inclusive.
Usage
get_mpfs(year, storage_path, keep_downloads = TRUE, locality)
Arguments
year |
integer (min = 14; max = 20) indicating MPFS database year |
storage_path |
path to storing downloaded files (temporarily if 'keep_downloads' equals 'FALSE') |
keep_downloads |
if 'TRUE', stores compressed CMS data to prevent re-downloading; if 'FALSE', deletes intermediate data after loading into R |
locality |
7-digit HCFS identification number; if not specified, will return entire MPFS database (all localities) |
Value
MPFS database for respective year and localities (data frame)
Examples
## Not run:
# get entire MPFS database for 2020
mpfs20 <- get_mpfs(20, storage_path = 'storage', keep_downloads = TRUE)
# get 2019 MPFS database only for carrier 15202 and locality 00
mpfs19 <- get_mpfs(19, storage_path = 'storage', locality = '1520200')
## End(Not run)
Locality dictionary for 2020 Physician Fee Schedule
Description
Asterisk indicates that payment locality is serviced by two carriers.
Usage
locality_dict
Format
data frame with 113 rows and 5 columns:
- Carrier Number
character; 5-digit carrier ID
- Locality
character; 2-digit locality ID
- State
character; uppercase, full U.S. state name
- Fee Schedule Area
character; description of fee schedule area
- Counties
character; counties included in Fee Schedule Area
Source
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/Locality
2020 Physician Fee Schedule, Ohio
Description
2020 Physician Fee Schedule, Ohio
Usage
mpfs20_oh
Format
data frame with 8994 rows and 15 columns:
- Year
numeric; 4-digit year
- Carrier Number
character; 5-digit carrier ID
- Locality
character; 2-digit locality ID
- HCPCS Code
character; CPT or level 2 HCPCS code for procedure
- Modifier
factor; payment schedule modifier
- PCTC Indicator
character; Professional Component/Technical Component Indicator
- Status Code
character; Medicare status code (e.g. A = Active code)
- Multiple Surgery Indicator
character; indicator of payment adjustment rules for multiple procedures
- 50% Therapy Reduction Amount (non-institutional)
numeric; multiple procedure therapy reduction amount (non-institutional)
- 50% Therapy Reduction Amount (institutional)
numeric; multiple procedure therapy reduction amount (institutional)
- OPPS Indicator
character; indicator as to whether Outpatient Prospective Payment System applies
- Facility Fee
numeric; reimbursement for procedure performed in a facility setting
- Non-Facility Fee
numeric; reimbursement for procedure performed in a non-facility setting
- OPPS Facility Fee
numeric; reimbursement for procedure performed in a facility setting if OPPS applies
- OPPS Non-Facility Fee
numeric; reimbursement for procedure performed in a non-facility setting if OPPS applies