Timeliness of Data

Overview

Medicare

The timeliness of Medicare Fee-for-Service data release is complicated. 

Medicare Part A, which includes Inpatient and Outpatient claims, is released on a six-month lag each quarter. That means new Q1 data for any given year is available in September of that year, Q2 data is available in December of that year, Q3 data in March of the following year, etc.

Part B, which covers data outside of the Inpatient and Outpatient setting, is released annually and on a much longer lag of eighteen months.

 

Commercial

The timeliness of commercial data will vary based on when it was purchased. Commercial claims are made available very quickly (<1 month lag), however, for the most recent months a significant claims may not be captured as these take time to be adjudicated.

 

Lag Time

The following table gives a more comprehensive breakdown of when the various data is released by the source. Once data is released from the source, we order it, upload it, and quality check it before it is available in the app. 

 

Data Source Lag Time Notes
Inpatient Claims CMS (Medicare) 6 months

Q1 2024 available Q4 2024

All 2024 available mid-summer 2025

Outpatient Claims CMS (Medicare) 6 months

Q1 2024 available Q4 2024

All 2024 available mid-summer 2025

Clinic (attached to hospital) CMS (Medicare) 6 months

Q1 2024 available Q4 2024

All 2024 available mid-summer 2025

Clinic (not attached to hospital) CMS (Medicare) 18 months 2022 CMS claims from unattached clinics available full year only mid-2024
Ambulatory Surgical Center CMS (Medicare) 9 months Aggregate counts
Sunshine Act Open Payments 9 months Data received in Aug or Sept of the following year
Affiliations

CMS (Medicare) Commercial

3 months Affiliations updated quarterly when new claims data is released
Physician Addresses NPPES, MCH Depends The NPPES database provides address information; we also verify from other sources and can override addresses in the app
Referrals

Careset CMS (Medicare)

3 - 18 months  
Referrals Commercial 1 month While we have access to claims only one month old, these do not comprise all claims from that time period as most take time to be adjudicated
Inpatient Claims Commercial 1 month While we have access to claims only one month old, these do not comprise all claims from that time period as most take time to be adjudicated
Outpatient Claims Commercial 1 month While we have access to claims only one month old, these do not comprise all claims from that time period as most take time to be adjudicated
Ambulatory Surgical Center Commercial 1 month While we have access to claims only one month old, these do not comprise all claims from that time period as most take time to be adjudicated