Program for Evaluating Payment
Patterns Electronic Report

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FATHOMIf you are with the Centers for Medicare & Medicaid Services (CMS) or a Medicare Administrative Contractor (MAC), Recovery Audit Contractor (RAC), Program Safeguard Contractor (PSC) or Zone Program Integrity Contractor (ZPIC), you may  request access to the secure section of this site. Within this section, you will have access to a demonstration version of the First-look Analysis Tool for Hospital Outlier Monitoring (FATHOM), the FATHOM User’s Guide and recorded and transcribed training sessions.

FATHOM is a Microsoft Access application designed to compare providers in areas at risk for improper Medicare payment using Medicare administrative claims data statistics.

There are two types of FATHOM:

  1. Short-term (ST) FATHOM – generates reports for short-term acute care hospitals that submit their claims to the MAC jurisdiction. Statistics are summarized in 12 three-month quarters. ST FATHOM is distributed on a quarterly basis, with the oldest quarter of statistics rolling off as the newest quarter is added.
  2. Other Hospital (OH) FATHOM – generates reports for other types of providers that submit their claims to the MAC jurisdiction:
    • Long-term acute care hospitals
    • Critical access hospitals
    • Inpatient psychiatric facilities
    • Inpatient rehabilitation facilities
    • Hospices
    • Partial hospitalization programs
    • Skilled nursing facilities
    Statistics are summarized in three 12-month time periods. OH FATHOM is distributed annually, with the oldest 12-month period rolling off as the newest 12-month time period is added.

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