CMS Program Data ‐ Populations1
Medicare (avg monthly)
CY 2020
CY 2021
CY 2022 2
Parts A and/or B
62.8
63.9
65.0
Aged
Disabled
54.5
8.3
55.9
8.0
57.3
7.7
Original Medicare Enrollment
37.8
36.4
35.1
MA & Other Health Plan Enrollment
25.1
27.5
29.8
MA Enrollment
24.4
26.9
29.1
Part D (MAPD+PDP)
47.4
48.8
50.3
Medicaid & CHIP
2020
2021
2022
Total 3
72.7
82.3
88.5
Dual Eligible (includes Aged, Disabled & ESRD)
8.0
11.6
‐‐
Children
35.7
38.9
40.6
Medicaid Expansion Adults
18.7
21.8
‐‐
SOURCES: CMS/Office of Enterprise Data & Analytics/Centers for Medicaid and CHIP Services
Medicare Deductibles, Coinsurance, Premiums
Part A
Inpatient Hospital Deductible Coinsurance/Day Coinsurance/LTR Day
Coinsurance/SNF Day
CY 2022
$1,556.00
$389.00
$778.00
$194.50
CY 2023
$1,600.00
$400.00
$800.00
$200.00
Part B
Deductible
$233.00
$226.00
Part D
Maximum Deductible Initial Coverage Limit
Out‐of‐Pocket Threshold
$480.00
$4,430.00
$7,050.00
$505.00
$4,660.00
$7,400.00
Premiums
Part A
Part B
$499.00 $506.00
$170.10‐$578.30 $164.90‐$560.50
SOURCE: CMS/Office of the Actuary
Original Medicare Persons Served and Payments by Type of Service Calendar Year 2021
Persons Served
(in millions)
Program Payments
(in billions)
Total
33.3
$396.1
Part A
6.7
$187.7
Inpatient Hospital
5.1
$131.3
Skilled Nursing Facility
1.4
$27.2
Home Health Agency
1.3
$6.1
Hospice
1.7
$23.1
Part B
32.7
$208.4
Physician/DME
32.1
$117.4
Outpatient
23.9
$80.3
Home Health Agency
1.8
$10.8
SOURCE: CMS/Office of Enterprise Data & Analytics
Original Medicare Persons Served (in Millions) by Type of Service Calendar Year 2021
Part A (Total 6.7 million) Part B (Total 32.7 million)
6.0 35.0
5.0
30.0
4.0
3.0
2.0
1.0
25.0
20.0
15.0
10.0
5.0
0.0
Inpatient Skilled Home Hospice Hospital Nursing Health
Facility Agency
0.0
Physician/DME Outpatient Home Health
Agency
Original Medicare Program Payments (in Billions) by Type of Service Calendar Year 2021
Part A (Total $187.7 billion) Part B (Total $208.4 billion)
Home
Hospice, Health
Home
$23.1
Agency,
Health $10.8
Agency,
$6.1
Skilled Nursing Facility,
$27.2
Inpatient Hospital,
$131.3
Total Program Payments, $396.1 billion
SOURCE: CMS/Office of Enterprise Data & Analytics
Medicare Part D Utilization and Expenditures
Calendar Year 2021
Utilizing Beneficiaries, in millions
47.6
Prescription Drug Events, in billions
1.5
Total Part D Expenditures, in billions
$104.9
Part D Benefit Payments
$104.4
Part D Administrative Expenses
$0.5
SOURCES: CMS/Office of Enterprise Data & Analytics/Office of the Actuary
Medicaid & CHIP Payments by Selected Type of Service Fiscal Year 2019
Payments (in billions)
Inpatient Services5 $64.0
Long‐Term Care5 $130.0
Physician, Laboratory and Other Services5 $96.0
Prescription Drugs5 $6.0
Managed Care $310.0
Administrative $30.0
SOURCE: CMS/Center for Medicaid and CHIP Services
Medicaid & CHIP Payments (in Billions) by Selected Type of Service Fiscal Year 2019
Physician, Laboratory, and Other Services,
$96.0
Prescription Drugs, $6.0
Managed Care,
$310.0
Long‐Term Care,
$130.0
Inpatient Services,
$64.0
Total Medicaid & CHIP Payments, $645.7
Administrative,
$30.0
SOURCE: CMS/Center for Medicaid and CHIP Services
Medicare Institutional Providers Calendar Year 2021
Type of Provider
Count
Total Hospitals
6,266
Short Stay
3,506
Psychiatric
622
Rehabilitation
332
Children's
91
Long Term
344
Critical Access
1,358
Religious Non‐Medical
13
Home Health Agencies
11,353
Skilled Nursing Facilities
14,908
Labs
311,775
Outpatient PT/Speech Pathology
2,023
Rural Health Clinics
5,009
Federally Qualified Health Centers
10,509
Ambulatory Surgical Centers
6,055
Comprehensive Outpatient Rehab Facilities
157
Hospices
5,966
SOURCE: CMS/Office of Enterprise Data & Analytics
CMS Fast Facts
March 2023 Version
Medicare Non‐Institutional Providers by Specialty6 Calendar Year 2021
Specialty Type
Count
Total Providers
1,444,008
Primary Care
222,065
Medical Specialties
180,247
Surgical Specialties
111,724
Emergency Medicine
50,660
Anesthesiology
43,493
Radiology
40,085
Obstetrics‐Gynecology
35,323
Psychiatry
27,631
Pathology
12,585
Non‐Physician Practitioners
548,738
Limited Licensed Practitioners
104,412
Ambulance Service Supplier
10,230
Opioid Treatment Programs
1,049
All Other Providers
78,345
SOURCE: CMS/Office of Enterprise Data & Analytics
Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Providers by Specialty
Calendar Year 20217
Specialty Type
Count
Total DMEPOS Providers
77,782
Pharmacy
46,203
Medical Supply Company
9,062
Podiatry
4,776
Optometry
3,993
Individual Certified Prosthetist/Orthotist
2,509
Orthopedic Surgery
2,106
General Practice
1,528
Optician
1,217
Ophthalmology
1,112
All Other DMEPOS Providers
5,416
SOURCE: CMS/Office of Enterprise Data & Analytics
Medicare Prepaid Contracts (01/2023)
Count
Total Prepaid Plans (MA and others)
967
Total Prescription Drug Plans
61
SOURCE: CMS/Center for Medicare
National Health Expenditures Calendar Year 2021
Total
$4,255.1
% of GDP
18.3%
Per Capita
$12,914
Health Insurance
$3,018.4
Private Health Insurance
$1,211.4
Medicare
$900.8
Medicaid (Title XIX)
$734.0
CHIP (Title XIX & XXI)
$22.3
Department of Defense
$43.9
Department of Veterans Affairs
$106.0
Dollars in billions except for Per Capita.
SOURCE: CMS/Office of the Actuary
CMSFinancialDataFiscalYear2022
Medicare Benefits 8 $971.2
TotalMedicaid9 $605.5
CHIP $16.7
Other Spending $11.9
TotalAppropriation $7,150.5
Other Sources $2,864.7
SOURCE: CMS/Office of Financial Management