Comparative Billing Reports (CBRs) are administered by the Centers for Medicare & Medicaid Services (CMS). These reports contain information about specific CPT code usage and are sent to individual providers to alert them to the potential over-utilization of these codes in the Medicare Fee-For-Service (FFS) program. Each report shows the provider how he/she compares to peers in the same specialty locally and nationally and is intended to give providers an opportunity to seek additional training and review Medicare guidelines to ensure compliance.
Announcements of new CBRs are made public, but individual comparative billing reports with physician-specific data will only be sent to providers that have been identified by CMS as at-risk.
At Fi-Med, we make this information available to our hospital and health network clients, who then use that data to run “what if” queries on their providers using our predictive analytic compliance dashboard, REVEAL/md. This allows our clients to stay ahead of government and commercial payer audits by identifying areas targeted by CMS prior to receiving a CBR alert.