Others titles

  • VM PUF 2016
  • Value Modifiers for 2016


  • Medical Billing
  • Billing Cost
  • Value Modifier
  • PUF Value Modifier
  • Common Procedure Coding System
  • Value Modifier PUF
  • Payment Adjustment
  • Medicare Shared Savings Program
  • Value Modifier Performance
  • Value Modifier Performance Results

Value Modifier PUF Performance Year 2016

This dataset shows the value modifier public use file (PUF) Performance Year 2016 (Payment Year 2018) by the Centers for Medicare and Medicaid Services (CMS).

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The Centers for Medicare and Medicaid Services (CMS) has created a standard analytical file intended to promote transparency. For each Value Modifier (VM) performance year, CMS publishes a public use file (PUF) that contains VM performance results of de-identified practices that were subject to the VM program. CMS provides supporting documentation for each PUF that contains the field name, length, type, label, description, and notes for each variable included in the PUF.

About this Dataset

Data Info

Date Created


Last Modified




Update Frequency


Temporal Coverage


Spatial Coverage

United States


John Snow Labs; Centers for Medicare & Medicaid Services;

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Source License Requirements


Source Citation



Medical Billing, Billing Cost, Value Modifier, PUF Value Modifier, Common Procedure Coding System, Value Modifier PUF, Payment Adjustment, Medicare Shared Savings Program, Value Modifier Performance, Value Modifier Performance Results

Other Titles

VM PUF 2016, Value Modifiers for 2016

Data Fields

Name Description Type Constraints
Practice_IDUnique identifier of practiceintegerlevel : Nominal
State_AbbreviationState in which practice is locatedstring-
Practice_EP_Count_CategoryPractice eligible professional count category (0 EPs=Zero eligible professionals. 1-9 EPs=One to nine eligible professionals. 10 to 99 EPs=10 to 99 eligible professionals. 100+ EPs=100 or more eligible professionals.)string-
Is_Practice_Enrolled_in_MSSPIndicator for whether the practice was a Medicare Shared Savings Program Accountable Care Organization practice in the performance year 2016boolean-
Is_GPRO_PracticeIndicator for whether practice registered to report data to the PQRS via the Group Practice Reporting Option (GPRO)boolean-
Is_Eligible_High_Risk_Bonus_AdjustmentIndicator for whether practice eligible for the additional upward payment adjustment for treating the disproportionate share of high-risk beneficiariesboolean-
PQRS_Minimum_RequirementPractice met minimum 2016 PQRS reporting requirementsstring-
Value_Modifier_Payment_AdjustmentValue Modifier payment in percentage for adjustment for practices subject to the Value Modifier. AF refers to a payment adjustment factor yet to be determined.string-
Updated_Value_Modifier_Payment_AdjustmentValue Modifier payment adjustment in percentage, incorporating Informal Review change, if applicable. AF refers to a payment adjustment factor yet to be determined.string-
Cost_Composite_Tier_DescriptionCost Composite Tier description determined based on Cost Composite Scorestring-
Quality_Composite_Tier_DescriptionQuality Composite Tier description determined based on Quality Composite Scorestring-
Standardized_Cost_Composite_ScoreStandardized Cost Composite Score, rounded to the nearest 0.01string-
Standardized_Quality_Composite_ScoreStandardized Quality Composite Score, rounded to the nearest 0.01string-

Data Preview

Practice IDState AbbreviationPractice EP Count CategoryIs Practice Enrolled in MSSPIs GPRO PracticeIs Eligible High Risk Bonus AdjustmentPQRS Minimum RequirementValue Modifier Payment AdjustmentUpdated Value Modifier Payment AdjustmentCost Composite Tier DescriptionQuality Composite Tier DescriptionStandardized Cost Composite ScoreStandardized Quality Composite Score
10000056203FL1 to 9 EPsFalseFalseCAT2-1.00%-1.00%
10000058339TX10 to 99 EPsFalseFalseFalseCAT100Average CostAverage Quality
10000077431CA1 to 9 EPsFalseFalseCAT2-1.00%-1.00%-0.34
10000105571FL1 to 9 EPsFalseFalseCAT2-1.00%-1.00%
10000140789NJ1 to 9 EPsFalseFalseCAT2-1.00%-1.00%
10000179271MO1 to 9 EPsFalseFalseCAT2-1.00%-1.00%-1.25
10000253527MS1 to 9 EPsFalseFalseCAT2-1.00%-1.00%
100003058141 to 9 EPsFalseFalseCAT2-1.00%-1.00%
10000330520MD1 to 9 EPsFalseFalseFalseCAT100Average CostAverage Quality-0.660.57
10000375652NC1 to 9 EPsFalseFalseFalseCAT100Average CostAverage Quality-0.07-0.24