CDC reports aggregate counts of COVID-19 cases and death numbers daily online. Data on the COVID-19 website and CDC’s COVID Data Tracker are based on these most recent numbers reported by states, territories, and other jurisdictions. This data set of “United States COVID-19 Cases and Deaths by State over Time” combines this information. However, data are dependent on jurisdictions’ timely and accurate reporting.
Separately, CDC also regularly reports provisional death certificate data from the National Vital Statistics System (NVSS) on data.cdc.gov. Details are described on the NCHS website. Reporting the number of deaths by using death certificates ultimately provides more complete information but is a longer process; therefore, these numbers will be less than the death counts on the COVID-19 website.
Accuracy of Data
CDC tracks COVID-19 illnesses, hospitalizations, and deaths to track trends, detect outbreaks, and monitor whether public health measures are working. However, counting exact numbers of COVID-19 cases is not possible. COVID-19 can cause mild illness, symptoms might not appear immediately, there are delays in reporting and testing, not everyone who is infected gets tested or seeks medical care, and there are differences in how completely states and territories report their cases.
COVID-19 is one of about 120 diseases or conditions health departments voluntarily report to CDC. State, local, and territorial public health departments verify and report cases to CDC. When there are differences between numbers of cases reported by CDC versus by health departments, data reported by health departments should be considered the most up to date. Health departments may update case data over time when they receive more complete and accurate information. The number of new cases reported each day fluctuates. There is generally less reporting on the weekends and holidays.
CDC reports death data on three other sections of the website: U.S. Cases & Deaths, COVID Data Tracker, and NCHS Provisional Death Counts. The U.S. Cases and Deaths webpages and COVID Data Tracker get their information from the same source (total case counts); however, NCHS Death Counts are based on death certificates that use information reported by physicians, medical examiners, or coroners in the cause-of-death section of each certificate. Data from each of these pages are considered provisional (not complete and pending verification) and are therefore subject to change. Counts from previous weeks are continually revised as more records are received and processed. Because not all jurisdictions report counts daily, counts may increase at different intervals.
Confirmed & Probable Counts
As of April 14, 2020, CDC case counts and death counts include both confirmed and probable cases and deaths. This change was made to reflect an interim COVID-19 position statement issued by the Council for State and Territorial Epidemiologists on April 5, 2020. The position statement included a case definition and made COVID-19 a nationally notifiable disease. Nationally notifiable disease cases are voluntarily reported to CDC by jurisdictions. Confirmed and probable case definition criteria are described here:
https://wwwn.cdc.gov/nndss/conditions/coronavirus-disease-2019-covid-19/case-definition/2020/. Not all jurisdictions report probable cases and deaths to CDC. When not available to CDC, it is noted as N/A. Please note that jurisdiction
Currently, CDC provides the public with COVID-19 case surveillance data in two ways: an 11 data element public use dataset of the line-listed dataset of all COVID-19 cases shared with CDC and a 31 data element restricted access dataset of the line-listed dataset of all COVID-19 cases shared with CDC.
The following are true for both the public use dataset and the restricted access dataset:
- Data are considered provisional by CDC and are subject to change until the data are reconciled and verified with the state and territorial data providers.
- Data are suppressed to protect individual privacy.
- The datasets include all cases with an initial report date of case to CDC at least 14 days prior to the creation of the previously updated datasets. This 14-day lag will allow case reporting to be stabilized and ensure that time-dependent outcome data are accurately captured.
- Datasets are updated monthly.
- Both datasets are created using CDC’s operational Policy on Public Health Research and Nonresearch Data Management and Access and include protections designed to protect individual privacy.
The COVID-19 case surveillance system database includes individual-level data reported to U.S. states and autonomous reporting entities, including New York City and the District of Columbia (D.C.), as well as U.S. territories and states. On April 5, 2020, COVID-19 was added to the Nationally Notifiable Condition List and classified as “immediately notifiable, urgent (within 24 hours)” by a Council of State and Territorial Epidemiologists (CSTE) Interim Position Statement (Interim-20-ID-01). CSTE updated the position statement on August 5, 2020 to clarify the interpretation of antigen detection tests and serologic test results within the case classification. The statement also recommended that all states and territories enact laws to make COVID-19 reportable in their jurisdiction, and that jurisdictions conducting surveillance should submit case notifications to CDC. COVID-19 case surveillance data are collected by jurisdictions and shared voluntarily with CDC.
The deidentified data in the public use dataset include demographic characteristics, exposure history, disease severity indicators and outcomes, clinical data, laboratory diagnostic test results, and comorbidities. All data elements can be found on the COVID-19 case report form located at www.cdc.gov/coronavirus/2019-ncov/downloads/pui-form.pdf.
The Case Surveillance Task Force and Surveillance Review and Response Group (SRRG) within CDC’s COVID-19 Response provide stewardship for datasets that support the public’s access to COVID-19 data while protecting individual privacy.
COVID-19 Case Reports
COVID-19 case reports have been routinely submitted using standardized case reporting forms. On April 5, 2020, CSTE released an Interim Position Statement with national surveillance case definitions for COVID-19 included. Current versions of
Deaths involving coronavirus disease 2019 (COVID-19), pneumonia, and influenza reported to NCHS by sex and age group and state.
NOTICE TO USERS: As of September 2, 2020, this data file includes the following age groups in addition to the age groups that are routinely included: 0-17, 18-29, 30-49, and 50-64. The new age groups are consistent with categories used across CDC COVID-19 surveillance pages. When analyzing the file, the user should make sure to select only the desired age groups. Summing across all age categories provided will result in double counting deaths from certain age groups.
Estimates of excess deaths can provide information about the burden of mortality potentially related to COVID-19, beyond the number of deaths that are directly attributed to COVID-19. Excess deaths are typically defined as the difference between observed numbers of deaths and expected numbers. This visualization provides weekly data on excess deaths by jurisdiction of occurrence. Counts of deaths in more recent weeks are compared with historical trends to determine whether the number of deaths is significantly higher than expected.
Estimates of excess deaths can be calculated in a variety of ways, and will vary depending on the methodology and assumptions about how many deaths are expected to occur. Estimates of excess deaths presented in this webpage were calculated using Farrington surveillance algorithms (1). For each jurisdiction, a model is used to generate a set of expected counts, and the upper bound of the 95% Confidence Intervals (95% CI) of these expected counts is used as a threshold to estimate excess deaths. Observed counts are compared to these upper bound estimates to determine whether a significant increase in deaths has occurred. Provisional counts are weighted to account for potential underreporting in the most recent weeks. However, data for the most recent week(s) are still likely to be incomplete. Only about 60% of deaths are reported within 10 days of the date of death, and there is considerable variation by jurisdiction. More detail about the methods, weighting, data, and limitations can be found in the Technical Notes.
The COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing and Treatment of the Uninsured Program provides reimbursements on a rolling basis directly to eligible health care entities for claims that are attributed to the testing and/or treatment of COVID-19 for uninsured individuals. The program is funded via the:
Families First Coronavirus Response Act (FFCRA) Relief Fund, which includes funds received from the Public Health and Social Services Emergency Fund, as appropriated in the FFCRCA (P.L. 116-127) and the Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139) (PPPHCEA), which each appropriated $1 billion to reimburse health care entities for conducting COVID-19 testing for the uninsured; and the Provider Relief Fund, which includes funds received from the Public Health and Social Services Emergency Fund, as appropriated in the Coronavirus Air, Relief, and Economic Security (CARES) Act (P.L. 116-136), which provides $100 billion in relief funds, including to hospitals and other health care entities on the front lines of the COVID-19 response and the PPPHCEA to reimburse health care entities for treating uninsured individuals with a COVID-19 diagnosis.
The PPPHCEA appropriated an additional $75 billion in relief funds. Within the Provider Relief Fund, a portion of the funding will be used to support healthcare-related expenses attributable to the treatment of uninsured individuals with COVID-19.
Health care entities that have conducted COVID-19 testing of uninsured individuals for COVID-19 or provided treatment to uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020, can request claims reimbursement through the program electronically and will be reimbursed generally at Medicare rates, subject to available funding.
This dataset represents the list of health care entities who have agreed to the Terms and Conditions and received claims reimbursement for COVID-19 testing of uninsured individuals and/or treatment for uninsured individuals with a COVID-19 diagnosis, as of November 25, 2020.
We are releasing data that compares the HHS Provider Relief Fund and the CMS Accelerated and Advance Payments by State and provider as of May 15, 2020. This data is already available on other websites, but this chart brings the information together into one view for comparison. You can find additional information on the Accelerated and Advance Payments at the following links:
This file was assembled by HHS via CMS, HRSA and reviewed by leadership and compares the HHS Provider Relief Fund and the CMS Accelerated and Advance Payments by State and provider as of December 4, 2020.
HHS Provider Relief Fund
President Trump is providing support to healthcare providers fighting the coronavirus disease 2019 (COVID-19) pandemic through the bipartisan Coronavirus Aid, Relief, & Economic Security Act and the Paycheck Protection Program and Health Care Enhancement Act, which provide a total of $175 billion for relief funds to hospitals and other healthcare providers on the front lines of the COVID-19 response. This funding supports healthcare-related expenses or lost revenue attributable to COVID-19 and ensures uninsured Americans can get treatment for COVID-19. HHS is distributing this Provider Relief Fund money and these payments do not need to be repaid.
The Department allocated $50 billion of the Provider Relief Fund for general distribution to Medicare facilities and providers impacted by COVID-19, based on eligible providers' net reimbursement. It allocated another $22 billion to providers in areas particularly impacted by the COVID-19 outbreak, rural providers, and providers who serve low-income populations and uninsured Americans. HHS will be allocating the remaining funds in the near future.
As part of the Provider Relief Fund distribution, all providers have 45 days to attest that they meet certain criteria to keep the funding they received, including public disclosure. As of May 15, 2020, there has been a total of $34 billion in attested payments. The chart only includes those providers that have attested to the payments by that date. We will continue to update this information and add the additional providers and payments once their attestation is complete.
CMS Accelerated and Advance Payments Program
On March 28, 2020, to increase cash flow to providers of services and suppliers impacted by the coronavirus disease 2019 (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) expanded the Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. Beginning on April 26, 2020, CMS stopped accepting new applications for the Advance Payment Program, and CMS began reevaluating all pending and new applications for Accelerated Payments in light of the availability of direct payments made through HHS’s Provider Relief Fund.
Since expanding the AAP program on March 28, 2020, CMS approved over 21,000 applications totaling $59.6 billion in payments to Part A providers, which includes hospitals, through May 18, 2020. For Part B suppliers—including doctors, non-physician practitioners and durable medical equipment suppliers— during the same time period, CMS approved almost 24,000 applications advancing $40.4 billion in payments. The AAP program is not a grant, and providers and suppliers are required to repay the loan.