Healthcare Data GlossaryRegulatory
CMS: Definition and Healthcare Context
Full name: Centers for Medicare & Medicaid Services
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the U.S. Department of Health and Human Services that administers Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Health Insurance Marketplace. CMS sets standards for health care quality, payment policy, and provider enrollment. The agency manages key public data systems including NPPES, PECOS, Care Compare, Open Payments, and the Quality Payment Program, and publishes provider, facility, and claims data used in health services research.
Last updated: 2026-06-17Reviewed by: Dr. Jennifer Montecillo, MD — Gullas College of Medicine, 2019. Non-practicing medical reviewer.
How it’s used
- CMS NPPES NPI Registry: CMS operates NPPES — the source for all NPI assignments and provider enumeration data.
- CMS PECOS Medicare Provider Enrollment: CMS administers PECOS for Medicare enrollment and billing rights management.
- CMS Care Compare: CMS publishes quality and inspection data for hospitals, nursing homes, dialysis facilities, home health agencies, hospices, and ASCs.
- CMS QPP MIPS: CMS runs the Quality Payment Program, publishing individual clinician performance scores annually.
- CMS Open Payments: CMS collects and discloses financial relationships between manufacturers and health care providers under the Sunshine Act.
Frequently asked questions
- What does CMS stand for?
- CMS stands for Centers for Medicare & Medicaid Services, the federal agency within HHS that administers Medicare, Medicaid, and CHIP.
- What public data does CMS publish?
- CMS publishes NPPES, PECOS, Care Compare, Open Payments, QPP MIPS scores, HCRIS cost reports, and dozens of other datasets through data.cms.gov.
- Who oversees CMS?
- CMS is part of the U.S. Department of Health and Human Services (HHS), which is a cabinet-level executive branch department.