This table shows us where the selected physician is having visits with patients. By looking at the different venues, it is easy to see, for example, the relative number of hospice patients seen by the physician in the private practice office, or in the hospital. For example, from the image below we can see that the physician sees far more hospice patients in the hospital than in a private office. There are three different locations that we identify for each physician:
- Hospital - This could include both inpatient or outpatient claims.
- Office - Reflects patient visits in the physician's office.
- SNF - Visits by the Physician in a Skilled Nursing Facility
- Unspecified - These could include patient's homes, nursing homes, clinics, etc.
This table only reflects professional claims, not institutional claims.
If a claim includes multiple settings, we include the count for that claim in the top option in this order of priority: Hospital, Office, Other.
All of the Place of Service Metrics are taken from the Part B (Professional) claims submitted under the Physician's NPI. The place of service code is entered into box 24b of form 1500. The existing codes are 01 through 99, (not all used). This table generates metrics based on the following codes:
- Hospital - code 21 or 22
- SNF - 31
- Office - code 11
- Unspecified - any other code. This is why there can be a lot of visits linked to this category
Understanding the Metrics
There are five metrics in the table:
- Place of Service - see above
- % Visits - Percentage of visits by this physician in the setting identified in the row.
- Visit Count - Count of visits this physician in the setting identified.
- All Patients - Count of distinct patients seen by this physician in the setting identified.
- All HOS Patients - Count of distinct patients who were seen by this physician, followed by a qualifying (ORIG or LC) HOS admit during the 1 year period and within 90 days of the physician visit.
What if there is no data?
Sometimes the table will contain no data and have the following note instead: "This data has been removed due to privacy suppression requirements."
This happens when we are unable to show counts or percentages because one of the metrics would reveal a patient count less than 11 (eleven). Since we have an actual patient count of all patients in other tables, some percentages would allow simple multiplication to discover a patient count less than eleven. If any of the metrics reach this level, we can't show any of the percentages because they would either not add up to 100%, or the hidden percentage could be calculated.