Utilization statistics and volumes by type of payer are obtained from a hospital's most recent Medicare cost
report. Data are updated on a quarterly basis as more recent information becomes available:
The presence of a clinical service is determined using
data from a hospital's most recent Medicare Cost Report,
Medicare inpatient claims data, Medicare outpatient claims
data, and other sources.
The
following specifications are based on the most common procedures
within a clinical service and may not include less common
procedures (i.e. the presence of the more common procedures was
used to test for the presence of a service). Due to AMA copyright restrictions CPT
procedure codes for outpatient services are not published on the
website.
Cardiovascular Services |
|
Cardiac Rehab |
More than ten Medicare outpatient claims for
outpatient cardiac rehabilitation |
|
Cardiac Cath Lab |
More than ten Medicare outpatient claims for left
heart catheterization AND/OR more than ten Medicare
inpatient claims for left or combined right and left
heart catheterization (ICD 37.22-37.23) |
|
Carotid Stenting |
Hospital meets the CMS minimum facility standards for performing carotid artery stenting for high risk patients.
|
|
Coronary Interventions |
More than
ten Medicare inpatient claims for removal of coronary
artery obstruction and insertion of stent(s) (ICD 36.0x and 00.66) |
|
Cardiac Surgery |
More than
ten Medicare inpatient claims for bypass anastomosis for
heart revascularization (ICD 36.1x) |
|
Electrophysiology |
More than
ten Medicare inpatient or outpatient claims for comprehensive
electrophysiologic evaluation (ICD 37.26 or selected CPT codes) |
|
Vascular Surgery |
More than
ten Medicare inpatient claims for resection of vessel
with replacement (ICD 38.44-38.45) and/or
aortic-iliac-femoral bypass (ICD 39.25) |
|
Vascular Intervention |
More than
ten Medicare outpatient claims for percutaneous
transluminal balloon angioplasty. |
Emergency
Services |
|
Emergency
Department |
More than
50 emergency department visits (based on estimated
volumes reported elsewhere on the hospital profile). |
|
ACS/COT
Approved Trauma Program |
Verification status provided by The American College of
Surgeons (ACS) Committee on Trauma (COT) Verification
Program. |
Neurosciences |
|
Electroencephalography (EEG) |
More than
ten Medicare outpatient claims for routine EEG and/or
special EEG tests. |
|
Sleep Studies |
More than
ten Medicare outpatient claims for sleep testing AND/OR
more than ten Medicare inpatient claims for
polysomnogram (ICD 89.17) |
Oncology Services |
|
Radiation Therapy |
More than
ten Medicare outpatient claims for delivery of radiation
therapy (6-19 MeV) |
|
Chemotherapy |
More than
ten Medicare outpatient claims for chemotherapy (HCPCS
C8953-C8955. J9000, J9999, and/or selected CPT codes) |
Orthopedic Services |
|
Arthroscopy |
More than
ten Medicare outpatient claims for arthroscopy with
meniscectomy (medial or lateral) |
|
Joint Replacement |
More than
ten Medicare inpatient claims for total hip replacement
(ICD 81.51) and more than ten Medicare inpatient claims
for total knee replacement (ICD 81.54). |
|
Spine Surgery |
More than
ten Medicare inpatient claims for spinal fusion (ICD
81.00-81.08), refusion of spine (ICD 81.30-81.39),
and/or certain other procedures on spine (ICD
81.63-81.66) |
Organ Transplant (Medicare certified) |
|
Heart |
Medicare
certification date as reported in the hospital's most
recent cost report (W/S S-2, part I, line 127, column 2) |
|
Intestinal |
Medicare
certification date as reported in the hospital's most
recent cost report (W/S S-2, part I, line 131, column 2) |
|
Kidney |
Medicare
certification date as reported in the hospital's most
recent cost report (W/S S-2, part I, line 126, column 2) |
|
Liver |
Medicare
certification date as reported in the hospital's most
recent cost report (W/S S-2, part I, line 128, column 2) |
|
Lung |
Medicare
certification date as reported in the hospital's most
recent cost report (W/S S-2, part I, line 129, column 2) |
|
Pancreas |
Medicare
certification date as reported in the hospital's most
recent cost report (W/S S-2, part I, line 130, column 2) |
Radiology / Nuclear Medicine / Imaging |
|
Computed
Tomography (CT) Scanner |
More than
ten Medicare outpatient claims for CT of head or brain,
pelvis, or abdomen |
|
Computed
Tomography Angiography (CTA) |
More than
ten Medicare outpatient claims for CTA of chest,
abdomen, pelvis, or neck |
|
Digital Mammography |
More than ten Medicare outpatient claims for digital mammography (selected CPT codes)
|
|
Intensity-Modulated
Radiation Therapy (IMRT) |
More than
ten Medicare outpatient claims for IMRT |
|
Magnetic
Resonance Angiography (MRA) |
More than
ten Medicare outpatient claims for MRA of abdomen (HCPCS
C8900-C8902), chest (HCPCS C8909-C8911). or lower
extremity (HCPCS C8912-C8914) |
|
Magnetic
Resonance Imaging (MRI) |
More than
ten Medicare outpatient claims for MRI of brain or
spinal canal |
|
Positron
Emission Tomography (PET) |
More than
ten Medicare outpatient claims for PET imaging of heart,
brain, and/or tumor (selected CPT codes) |
|
Single
Photon Emission Computerized Tomography (SPECT) |
More than
ten Medicare outpatient claims for SPECT single or
multiple studies |
Rehabilitation Therapies |
|
Speech
Therapy |
More than
ten Medicare outpatient claims for aural rehabilitation |
|
Physical
Therapy |
More than
ten Medicare outpatient claims for therapeutic exercises
to develop strength, endurance, range of motion, and
flexibility. |
Surgery |
|
Bariatric Surgery |
Hospital meets the CMS minimum facility standards for bariatric surgery and has been certified by ACS and/or ASBS.
|
|
Inpatient Surgery |
More than ten Medicare inpatient claims for surgical DRGs |
|
Radiosurgery |
More than ten Medicare claims for CyberKnife, GammaKnife, SRS, etc. (HCPCS G0339, G0340, G0173, G0251 and selected CPT codes)
|
|
Robotic Surgery |
More than ten Medicare claims for computer assisted robotic surgery (ICD 17.41-17.49 and selected CPT codes)
|
Wound Care |
|
Hyperbaric
Oxygen |
More than
ten Medicare outpatient claims for hyperbaric oxygen (HCPCS
C1300) |
|
Wound
Care |
More than
ten Medicare outpatient claims for removal of
devitalized tissue from wounds (selected CPT codes) |
Other
Services |
|
Hemodialysis |
More than
ten Medicare inpatient claims for hemodialysis (ICD
39.95) |
|
Home Health |
Hospital-based home health agency per the hospital's
most recent cost report (W/S S-2, part I, line 12, column 2 or
3) |
|
Hospice |
Hospital-based hospice per the hospital's most recent
cost report (W/S S-2, part I, line 14, column 2 or 5) |
|
Lithrotripsy
(ESWL) |
More than
ten Medicare outpatient claims for extracorporeal shock
wave lithotripsy |
|
Obstetrics |
More than
50 births (based on estimated volumes reported elsewhere
on the hospital profile). |
Subprovider Units |
|
Psychiatric |
Beds
designated in a psychiatric distinct part unit (DPU) per
the hospital's most recent cost report (W/S S-3, part 1,
line 16, column 2) |
|
Rehabilitation |
Beds
designated in a rehabilitation distinct part unit (DPU)
per the hospital's most recent cost report (W/S S-3,
part 1, line 17, column 2) |
|
Skilled
Nursing (SNF) |
Designated
skilled nursing beds per the hospital's most recent cost
report (W/S S-3, part 1, line 19, column 2) |
|
Nursing
Facility (NF) |
Designated
nursing facility beds per the hospital's most recent
cost report (W/S S-3, part 1, line 20, column 2) |
|
Swing Beds - SNF |
Designated
SNF swing bed revenue per the hospital's most recent
cost report (W/S G-2, part 1, line 5, column 3) |
|
Swing Beds
- NF |
Designated
NF swing bed revenue per the hospital's most
recent cost report (W/S G-2, part I, line 6, column 3) |
Special Care |
|
Intensive Care Unit (ICU) |
Beds
designated in an ICU per the hospital's most recent cost
report (W/S S-3, part 1, line 8, column 2) |
|
Coronary Intensive Care (CCU) |
Beds
designated in a CCU per the hospital's most recent cost
report (W/S S-3, part 1, line 9, column 2) |
|
Burn Intensive Care (BICU) |
Beds
designated in a BICU per the hospital's most recent cost
report (W/S S-3, part 1, line 10, column 2) |
|
Surgical Intensive Care (SICU) |
Beds
designated per the hospital's most recent cost
report (W/S S-3, part 1, line 11, column 2) |
|
Psychiatric Intensive Care |
Beds
designated per the hospital's most recent cost
report (W/S S-3, part 1, line 12.05, column 2) |
|
Pediatric Intensive Care |
Beds
designated per the hospital's most recent cost
report (W/S S-3, part 1, line 12.10, column 2) |
|
Neonatal Intensive Care |
Beds
designated per the hospital's most recent cost
report (W/S S-3, part 1, line 12.15, column 2) |
|
Trauma Intensive Care |
Beds
designated per the hospital's most recent cost
report (W/S S-3, part 1, line 12.20, column 2) |
|
Detox Intensive Care |
Beds
designated per the hospital's most recent cost
report (W/S S-3, part 1, line 12.25, column 2) |
|
Premature Intensive Care |
Beds
designated per the hospital's most recent cost
report (W/S S-3, part 1, line 12.30, column 2) |