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THE RIGHT DATA TO THE RIGHT PEOPLE AT THE RIGHT TIME.
The Beneficiary Claims Data API (BCDA) gives organizations the insights they need to provide high quality, coordinated care. BCDA uses the FHIR® standard as a simple, flexible, and effective way to receive Medicare Part A, B, and D claims.
Try the API
BCDA logo
Currently Available To:
  • ACO REACH
  • Kidney Care Choices (KCC)
  • Medicare Shared Savings Program ACOs
How does BCDA benefit participants?
BCDA boosts your data insights
Improve

BCDA expands insight into assigned beneficiary populations with Medicare claims data.

BCDA increases claims requests
Decrease Time

BCDA enables automated claims data updates at least 1x/week.

BCDA standardizes the claims format
Accessibility

BCDA offers Medicare claims data in the FHIR® format, an HL7® healthcare interoperability standard referenced in the CMS interoperability rule.

BCDA logo
Sounds Great!
Where can I start?
Try the API
Learn about BCDA Data
Join our Community for Updates

The Latest & Greatest from BCDA!

The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the initial production release of the Beneficiary Claims Data Application Programming Interface (BCDA) Partially Adjudicated Enhancement on May 16th, 2023. This initial release was designed as an expansion of the data available to Medicare providers from BCDA and is available to Accountable Care Organizations (ACOs) participating in the ACO Realizing Equity, Access, and Community Health (ACO REACH) Model.

For more information on partially adjudicated claims, the User Guide can be found here and the Data Dictionary can be found here.

Frequently Asked Questions

1. Are Claim and Claim Line Feed (CCLF) files going away?

No, CCLF files are not going away. BCDA supplements the data that participants already receive for the Shared Savings Program (which may include CCLF files). Contact SharedSavingsProgram@cms.hhs.gov or your respective model with questions about CCLF files.

2. How can BCDA eligible participants generate credentials?

  • ACOs can generate BCDA credentials using the ACO Management System (ACO-MS).
  • KCC and ACO REACH models can generate BCDA credentials using the 4innovation portal.

If you are interested in using BCDA, contact your respective model. As additional models are able to use the API, we'll share updates with you here and in BCDA's Google Group.

We encourage participants and their vendor partners to try the API in the sandbox environment with synthetic data. You don't need credentials to use the sandbox.

3. How can I share my feedback?

Join the BCDA Google Group to share feedback. You can also learn from other participants and talk to the BCDA research and development team. Your firsthand experience helps shape the API.
CMS Claims-Based FHIR APIs
BCDA is one of several CMS APIs that offer Medicare claims data sharing in FHIR format.
Check out these other CMS APIs for more information:
Data at the Point of Care API logo
The Data at the Point of Care API enables healthcare providers with claims data to fill-in gaps in patient history at the point of care and deliver high quality care to Medicare beneficiaries.
DPC
Blue Button 2.0 API logo
The Blue Button 2.0 API enables beneficiaries to connect their Medicare claims data to the applications, services, and research programs they trust.
BB 2.0
AB2D API logo
The AB2D API provides stand-alone PDP sponsors with Medicare Parts A and B claims data for their active enrollees.
AB2D