Harness Claims Data to Deliver Value-Based Care
Beneficiary Claims Data API (BCDA) helps organizations deliver value-based care. Using innovative healthcare standards, BCDA enables organizations to integrate Medicare claims data into their tracking, reporting, and performance systems for more coordinated and person-centered care.
Who uses BCDA?
BCDA helps organizations in CMS Alternative Payment Models lower costs and improve beneficiary care. Participating model groups include:
BCDA Use Cases
Real-time monitoring and reporting
Track performance, utilization, and shared cost savings with timely insights that support early interventions.
Get claims data in days, not weeks
BCDA claims data is available 2-14 days after submission. This means enrollees can receive time-sensitive care when it matters most. See a timeline of the claims data process.
Fill gaps in patient data
Supplement data from EMRs, ADT feeds, and other sources to get a holistic overview of your enrollees' health histories and provide preventative care.
Receive standardized FHIR claims data
Get interoperable claims data that follows the HL7 Healthcare Interoperability Standard required by Centers for Medicare & Medicaid Services (CMS).
Using the data
BCDA is an Application Programming Interface (API) that updates enrollee claims data at least once a week. Data is provided in NDJSON format and includes:
- Medicare enrollee identifiers
- diagnosis codes
- dates and times of service
Featured
Get claims data sooner with partially adjudicated claims
Through BCDA, health care organizations can access claims 2 to 4 days after they’re submitted instead of 14 or more. These “partially adjudicated” claims have valuable data but haven’t been fully processed and paid by Medicare systems.
Announcements
BCDA v3 goes live July 1, 2026
BCDA v3 will offer more frequent updates, easier tracking and filtering, and more conformance with FHIR standards. It will become available for current BCDA users on July 1.
Watch this space and the BCDA Google Group for links to migration guides and info about office hours support.
