CIVHC uses the Centers for Medicare & Medicaid Services (CMS) minimum threshold rule requiring that facilitie
CIVHC uses the Centers for Medicare & Medicaid Services (CMS) minimum threshold rule requiring that facilities have eleven or more of the same service represented in the dataset in order to release results. Some facilities not listed may provide more than eleven of a particular service or procedure in a typical calendar year, but after the data is cleaned and processed, may not have had enough claims to be included. It is important to remember that the Shop for Care tool also only includes commercial claims, and does not include the majority of self-insured commercial claims or Medicare and Medicaid claims, which represents a large portion of the volume of claims for many facilities. In addition, due to a Colorado law, CIVHC cannot currently report on physician group prices for services that can be performed in a doctor’s office until quality measures are available for those providers. If you are interested in price information at a facility not listed, contact your health plan or the facility directly for more information, or contact us at firstname.lastname@example.org.