Comparative Billing Report (CBR) information is available to providers by request. The Comparative Billing Report compares your specific billing practice to that of your assigned provider specialty. A CBR may be a helpful tool when conducting self-audits.
***Please be aware that a CBR cannot be produced using a group Medicare number. Each report is provider specific and produced per Provider Transaction Access Number (PTAN) or National Provider Identifier (NPI). If a provider is requesting reports for more than one of his/her PTAN/NPIs, each report is separate and a separate fee is required.***
Medicare updates the data two times per year for the following dates of service:
- January through June
- July through December
Since Medicare bases a CBR on dates of service and not processed dates, Medicare must allow three to four months to permit claims to be finalized before a report can be generated. For example, the January through June timeframe is not available until September or October.
If you are interested in receiving these individualized reports or graphs, complete the Request for Comparative Billing Report for Alabama, Georgia and/or Tennessee. The purchase price per PTAN is $40.00, which covers the cost of production and shipping.
Source: CMS Pub 100-08, Medicare Program Integrity Manual, Chapter 3, Section 126.96.36.199