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Healthcare Data DatasetPlatform-seededFree

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Healthcare: Medicare Cost-Sharing & Payment Benchmarks 2025

A free, platform-curated reference of the headline Medicare cost-sharing, premium, and payment benchmarks that anchor U.S. healthcare pricing. Every figure is public-domain data published by the Centers for Medicare & Medicaid Services and the IRS, with the applicable calendar year marked on each record. Useful for revenue-cycle teams, actuaries, and health-tech builders who need authoritative baseline numbers without licensing costs.

0 sold 400 views7/14/2026
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{
  "_type": "curated_open_data",
  "as_of": "2026-07",
  "links": {
    "canonical": "https://verticalmarketplace.ai",
    "docs_for_llms": "https://verticalmarketplace.ai/llms.txt",
    "sell_your_own": "https://verticalmarketplace.ai/api/marketplace/listings",
    "vertical_listings": "https://verticalmarketplace.ai/api/marketplace/listings?vertical=healthcare"
  },
  "records": [
    {
      "unit": "USD per benefit period",
      "value": "1676",
      "metric": "Medicare Part A inpatient hospital deductible",
      "period": "CY2025",
      "source": "CMS"
    },
    {
      "unit": "USD per day",
      "value": "419",
      "metric": "Medicare Part A coinsurance, hospital days 61-90",
      "period": "CY2025",
      "source": "CMS"
    },
    {
      "unit": "USD per day",
      "value": "838",
      "metric": "Medicare Part A lifetime reserve day coinsurance",
      "period": "CY2025",
      "source": "CMS"
    },
    {
      "unit": "USD per day",
      "value": "209.50",
      "metric": "Skilled nursing facility coinsurance, days 21-100",
      "period": "CY2025",
      "source": "CMS"
    },
    {
      "unit": "USD per month",
      "value": "185.00",
      "metric": "Medicare Part B standard monthly premium",
      "period": "CY2025",
      "source": "CMS"
    },
    {
      "unit": "USD per year",
      "value": "257",
      "metric": "Medicare Part B annual deductible",
      "period": "CY2025",
      "source": "CMS"
    },
    {
      "unit": "percent of approved amount",
      "value": "20",
      "metric": "Medicare Part B coinsurance after deductible",
      "period": "current",
      "source": "CMS"
    },
    {
      "unit": "USD per RVU",
      "value": "32.3465",
      "metric": "Medicare Physician Fee Schedule conversion factor",
      "period": "CY2025",
      "source": "CMS"
    },
    {
      "unit": "USD per month",
      "value": "36.78",
      "metric": "Medicare Part D national base beneficiary premium",
      "period": "CY2025",
      "source": "CMS"
    },
    {
      "unit": "USD per year",
      "value": "2000",
      "metric": "Medicare Part D annual out-of-pocket cap",
      "period": "CY2025",
      "source": "CMS (Inflation Reduction Act)"
    },
    {
      "unit": "USD per year",
      "value": "15650",
      "metric": "Federal poverty guideline, household of one (48 states + DC)",
      "period": "2025",
      "source": "HHS"
    },
    {
      "unit": "percent of wages",
      "value": "2.9",
      "metric": "Medicare Hospital Insurance payroll tax rate (combined)",
      "period": "current",
      "source": "IRS/SSA"
    },
    {
      "unit": "percent above 200,000 USD",
      "value": "0.9",
      "metric": "Additional Medicare Tax on high earners (single)",
      "period": "current",
      "source": "IRS"
    }
  ],
  "sources": [
    {
      "url": "https://www.cms.gov/newsroom/fact-sheets/2025-medicare-parts-b-premiums-and-deductibles",
      "name": "CMS — 2025 Medicare Parts A & B Premiums and Deductibles"
    },
    {
      "url": "https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines",
      "name": "HHS — Poverty Guidelines"
    },
    {
      "url": "https://www.irs.gov/taxtopics/tc751",
      "name": "IRS — Topic No. 751, Social Security and Medicare Withholding Rates"
    }
  ],
  "category": "benchmarks",
  "vertical": "healthcare",
  "data_note": "All records are public-domain facts compiled from the cited sources as of the asOf date. This content is authored and served by the platform itself — it is not seller data, so the marketplace's zero-storage promise about seller datasets is unaffected.",
  "record_count": 13,
  "what_this_is": "A platform-published open-data listing curated by Open Data Desk, the marketplace's in-house public-data seller. It is real free inventory: it counts in marketplace statistics and is purchasable for $0 through the normal purchase flow, which delivers this payload with an Ed25519-signed receipt.",
  "record_schema": {
    "unit": "Unit of measure (USD, percent, per day, etc.)",
    "value": "Published amount, rate, or percentage",
    "metric": "Name of the benchmark or cost-sharing amount",
    "period": "Calendar year or period the figure applies to",
    "source": "Public agency that publishes the figure"
  },
  "buyer_use_cases": [
    "Seed revenue-cycle and patient-estimation tools with authoritative Medicare cost-sharing baselines.",
    "Give actuaries and analysts a citable set of premium, deductible, and payment benchmarks for modeling."
  ]
}

The full dataset is delivered after purchase. Fingerprint: sha256:ab653d757ffd1c15be35ec802eadd43187717bf86e6ce1a544721b359cac9096

Questions & answers

No answered questions yet — ask the seller anything about this listing.

License — Vertical Marketplace Data License v1

Data is contributed by independent third-party sellers. Vertical Marketplace facilitates the transaction; sellers keep 95% on everyday sales from $20 to $49,999.99 under the year-one founding rate locked through 2027-06-30 (full schedule: GET /api/meta). Prohibited content (digital keys/licenses/game codes, and health data the seller does not own — e.g. patient records) is not permitted; individuals may sell their own personal health data only via the signed Health Data Consent Flow. See /terms.

Permitted
  • Use the purchased data for your own commercial and non-commercial work
  • Create derivative analyses, models, and works from the data
Restricted
  • No reselling or re-listing the purchased data on this or any other marketplace
  • No redistributing the raw data payload as-is to third parties
  • Exclusive listings are sold to a single buyer and delisted on purchase
  • Limited listings are sold to a capped number of buyers and delisted once sold out
Price
FREE
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Seller
S-000002
Platform-affiliated seller — common ownership
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