We need your feedback & comments
The MACRA required us to ask for your feedback.
How can I learn about the Patient Relationship Categories & Codes?
- Read more, based on your comments, about patient relationship categories and how we may use CPT Modifiers for reporting patient relationship codes.
- View slides, transcripts, and recordings and an FAQ from the 2/21/18 and the 10/17/18 Patient Relationship Categories & Codes webinars.
2019 MIPS cost performance category resources
- 2019 cost measure code lists that detail the cost measure code lists for each of the 8 episode-based cost measures that are new for the Cost performance category in 2019.
- 2019 cost measure information forms that detail the measure methodology for each of the 8 episode-based cost measures that are new for the Cost performance category in 2019 and provides an overview of the 2019 TPCC and MSPB cost measures that were established for the Merit-based Incentive Payment System (MIPS) in 2018.
- 2019 Merit-based Incentive Payment System (MIPS): Summary of cost measures. This provides a summary of cost measures in relation to MIPS.
2018 cost measure field testing
In October 2018, we field tested 11 newly developed episode-based cost measures and 2 revised measures for consideration in MIPS. Field testing happened from October 3, 2018 - October 31, 2018, with an extension to November 5, 2018. During field testing clinicians and clinician groups were able to get Field Test Reports from the CMS Enterprise Portal and give feedback on the draft measure specifications, field test report templates, and supplemental documentation. These reports were for field testing only, and don’t affect any scoring or payment adjustments.
Note: Field test reports are no longer available on the CMS Enterprise Portal, as of January 2019.
You can review our:
- Fact sheet, which gives you basic information about the cost measures and the field testing process.
- FAQs, which provide more information on these topics in a question and answer format.
- Sample Mock Field Test Reports for each of the measures that were field tested:
You can also review updated measure specifications, measure justification forms, and supplemental documents for the 11 episode-based cost measures and the revised TPCC and MSPB measures, including refinements based on field testing feedback:
- The Episode-Based Cost Measures zip file includes a cost measure methodology document and a measure codes list file for each of the 11 episode-based cost measures.
- The revised MSPB clinician zip file includes a cost measure methodology document and a measure codes list file for the revised measure.
- The revised TPCC zip file includes a cost measure methodology document and measure codes list file for the revised measure.
- The Measure Justification Forms zip file contains Measure Justification Forms for the 11 episode-based cost measures and the revised TPCC and MSPB measures that contain a comprehensive characterization of the measures, their justification, and testing results.
- Updated 2018 National Summary Data Report contains an updated report that provides national-level summary statistics on clinicians’ performance for the cost measures following refinements made after the field testing period, as well as an addendum with risk adjustment regression results for the cost measures.
- The Field Testing Feedback Summary Report provides a summary of feedback and refinements made to the cost measures after the field testing period.
MACRA cost measure development
There have been many opportunities for stakeholders to provide input throughout the process. Learn more about the MACRA cost measure development process from:
- Measure development process document describes our approach to episode-based cost measure development.
- Person & Family Committee Guiding Principles shows high-level guiding principles developed from structured patient and caregiver interviews to inform cost measure development.
- Stakeholder Input Opportunities lists many ways to participate in the development process.
Learn about the Care Episodes & Patient Condition Codes
- Proposed revisions to the 2018 Operational List of Care Episode & Patient Condition Codes. These revisions are proposed in the CY 2020 Physician Fee Schedule Proposed Rule and may change.
- 2018 Operational List of Care Episode & Patient Condition Codes (zip) 1/23/2018
Prior feedback requests:
- Previous Cost Measure Field Testing
- 2018 study on burdens associated with reporting quality measures to get Improvement Activity credit for 2018.
- The MACRA RFI.
- The Draft CMS Quality Measure Development Plan (MDP).
- Annual call for measures & activities. You can read our fact sheet and attend our webinar for a walkthrough of the process.
- Previous episode groups summary and details, and supplemental episode groups materials.
- Draft list of episode groups and trigger codes (December 2016).
- Page last Modified: 07/29/2019 3:38 PM
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