Physical therapists (PTs) and occupational therapists (OTs) in Polk County, Texas—county seat Livingston—must not get much sleep, because according to the Centers for Medicare and Medicaid Services (CMS), between 2015 and 2016, CMS has paid claims related to an average of 249.3 users per provider.
Out in big sky country, however, things are a little different: if you happen to be a PT or OT in Broadwater County, in central Montana, PTs and OTs averaged only 26 users per provider during the same time period.
That's just a taste of some of the data available in the latest update to the CMS "market saturation and utilization data tool," an interactive map that pulls from data used by CMS to, among other things, gauge potential fraud, waste, and abuse by getting a fairly granular sense of provider numbers and beneficiaries served.
CMS says that it makes these data public "to assist health care providers in making informed decisions about their service locations and the beneficiary population they serve." Physical therapy and occupational therapy data are tied to Medicare Part B claims.
The maps, scalable to a county-by-county level, reflect a 12-month study period, the most recent running from July 1, 2015, to June 30, 2016. Users can choose the most recent or an earlier reference period, a "health service area" (physical therapy and occupational therapy are merged; other categories include home health and skilled nursing facilities), and a specific metric: number of fee-for-service beneficiaries, number of providers, average number of users per provider, percentage of users out of fee-for-service beneficiaries, and average number of providers per county. Finally, the map can be adjusted to reflect data related to whether an area has been under a CMS provider enrollment moratorium.
The resource also includes two appendices: a pdf document that describes the parameters of the data set (including the CPT codes used to define physical therapy and occupational therapy), and an interactive data set that allows users to sort the entire range of results.