Healthcare Payments

Procedure Counts

The procedure count on CompareMaine represents the estimated number of times a healthcare setting performed the service or procedure, as reported in MHDO’s APCD, as required in 90-590 CMR Chapter 243, Uniform Reporting System for Health Care Claims Data Sets. The procedure counts include claims for both commercial and public payors; it does not include counts of services not reported in the MHDO APCD.

To calculate procedure counts, each unique combination of APCD member ID, healthcare setting ID, service or procedure code, and service date is assigned a count of 1. For commercial and Medicaid (MaineCare), the procedure counts are for April 1, 2022 - March 31, 2023, whereas for Medicare the procedure counts are for October 1, 2021 - September 30, 2022 (most current data available).

Counts are rounded to the highest multiple of 10 before they are displayed on the CompareMaine (for example, 12, 15, and 19 are all rounded to 20).