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The Beneficiary Claims Data API (BCDA) enables Accountable Care Organizations (ACOs) to retrieve Medicare Part A, Part B, and Part D claims data for their assigned beneficiaries. BCDA is currently serving ACOs participating in the Medicare Shared Savings Program and other eligible CMS Alternative Payment Models.
BCDA logo
How can ACOs benefit from BCDA?
Supplement Insights

BCDA supplements ACOs' insight into their assigned beneficiary populations with Medicare claims data.

Decrease Time
Enable ACOs

BCDA enables ACOs to make claims data requests more often - once a week.

Standardize Claims Format

BCDA offers Medicare claims data in a format that is aligned with a healthcare interoperability standard and the CMS interoperability rule.

Frequently Asked Questions

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

No, CCLF files are not going away. BCDA is meant to supplement the data that ACOs already receive for the Shared Savings Program or other eligible model participation, which may include CCLF files. Please contact or your respective model with questions about CCLF files.

2. Can my ACO use BCDA?

  • Currently, all Medicare Shared Savings Program ACOs are able to use BCDA. Please generate BCDA credentials using the ACO Management System (ACO-MS).
  • BCDA is evaluating support for models developed by the Center for Medicare and Medicaid Innovation. If your ACO is interested in using BCDA, please contact your respective model. As additional ACO models are able to use the API, we will share information on this website and in BCDA's Google Group.
  • You don't need credentials to use the sandbox environment. All ACOs and their vendor partners are encouraged to try the API in the sandbox environment with synthetic data.

3. How can I share my feedback?

BCDA is built in accordance with feedback from ACOs and their vendor partners. You are invited and encouraged to share feedback with CMS when using BCDA in sandbox or production to ensure we are creating an API that meets your organization’s needs. Join BCDA’s Google Group to connect with other participating organizations and BCDA’s research and development team.

The Latest & Greatest from BCDA!

Changes to BCDA during January 2021 for new year attribution
December 29 2020

The production API is undergoing a change that will affect your use of BCDA in the remainder of December 2020 and throughout January 2021.

Why the change?

Between December and January, ACOs go through a change in their participant lists and related beneficiary assignment as part of the transition between performance years. BCDA has a delay in receiving the updated beneficiary list in January, so BCDA has been working to ensure that we only return appropriate claims data. Last year, BCDA had to be turned off to address this delay; this year, BCDA is releasing new capabilities to maintain its uptime year-round.

BCDA is introducing a new identifier in the /Group endpoint, called `runout`. Between December 2020 and mid-January 2021, this identifier will only return claims with a service date before December 31, 2020. Until BCDA receives January 2021 attribution information, the only way to retrieve claims is to use the group ID `runout` with the /Group endpoint; requests to /Patient or /Group with other group IDs will fail. After BCDA receives January 2021 attribution information, this same `runout` identifier will also be available for ACOs to receive claims runout information from 2020.

Full details about how to implement these changes are available in the End of Year Requests section on the Building Your API page.

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.
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.
AB2D API logo
The AB2D API provides stand-alone PDP sponsors with Medicare Parts A and B claims data for their active enrollees.