12/31/2025 data cutoff?

[Jake Halpert]

Hi DPC Team -

As always, first of all thank you for your continue attention/support of this critical service.

My team noticed that as of a few days ago, there appears to be a de facto cutoff of billablePeriod.end = 2025-12-31 in the EOBs returning from the BFD server via the DPC API. This is unusual compared to past years, where there would have by the middle of January start to appear adjudicated EOBs with service dates January 1st, 2nd etc. DPC API queries continue to respond without error, but limited to EOBs with period ends thru 12/31/2025.

We are aware that BCDA data endpoints do not sync the new beneficiary roster until later in January and so the BCDA API must be used exclusively with _runout mode for much of January, but that has not been the case with DPC given it's a totally different query functionality/paradigm.

Are you aware of any changes in BFD maintenance and/or DPC API behavior that would result in this phenomena, and if so do you have any guidance on when the API would return to normal function?

Best,

Jake

[Data at the Point of Care (DPC) Community]

Hi Jake,

Thanks for your question regarding your observations on the EOBs being returned from the API. We're reviewing the information you shared and will get back to you shortly.

Thank you,

The DPC API Team

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.

[Jacob]

Thank you team as always for your support. Will stand by with the team for information.

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[Data at the Point of Care (DPC) Community]

Hi Jake,

We do see that some claims with service dates after 12/31/2025 are beginning to flow in, but not all of them yet. This appears consistent with normal claims processing and ingestion delays, particularly early in the new year.

Specifically:

• Carrier claims (which tend to process faster) are starting to appear, though not comprehensively yet.
• Institutional claims (e.g., inpatient) have a longer adjudication timeline and have not fully reached our data pipeline at this point.

At this time, we don’t see any indication of an issue with the DPC API itself or with the data ingestion. Based on current processing timelines, we expect additional records to appear in upcoming loads.

We’ll continue to monitor, but no action is needed on your end. Please let us know if you continue to see unexpected gaps after the next few data refreshes.

Thanks again for raising this!

Best,

The DPC API Team, 

Please be careful not to share either Personally Identifiable Information (PII) as defined in the Privacy Act of 1974 or Protected Health Information (PHI) when communicating with our team via email or in our Google Group. In certain circumstances, CMS may ask you to provide a data file to assist us in troubleshooting a problem that you bring to our attention. In those instances, we will provide you with instructions for how to handle the transmission.