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2022 MIPS cost performance category resources

  • 2022 Cost Measure Information Forms (ZIP) detail the cost measure methodology for each of the 23 episode-based cost measures and the revised Medicare Spending Per Beneficiary (MSPB) Clinician and Total Per Capita Cost (TPCC) measures that are in use for the cost performance category in 2022.
  • 2022 Cost Measure Codes Lists (ZIP) detail the cost measure codes list for each of the 23 episode-based cost measures and the revised MSPB Clinician and TPCC measures that are in use for the cost performance category in 2022.
  • 2022 MIPS Summary of Cost Measures (PDF) provides a summary of cost measures in use for MIPS in 2022 as well as measures under development.

Wave 4 cost measures field testing

From January 10 to March 25, 2022, we field tested 5 newly developed Wave 4 episode-based cost measures for consideration in MIPS. During field testing, eligible clinicians and clinician groups were able to download their Field Test Reports from the Quality Payment Program website and give feedback on the draft measure specifications. These reports were for field testing only, and don’t affect any scoring or payment adjustments.

Learn more:

  • Frequently Asked Questions (FAQ) (PDF) gives you information about the cost measures and field testing in a question and answer format.
  • Wave 4 Measure Development Process (PDF) describes our approach to measure development.
  • User Access Guide (PDF) explains how to access your Field Test Report(s) on the Quality Payment Program website.
  • Mock Field Test Reports (ZIP) contains 3 sample Field Test Reports that are representative of each measure type and reporting level. Each zip file includes a PDF Field Test Report, a supplemental comma-separated values (CSV) file with episode-level data, and the data dictionary for the metrics used in the CSV file.

You can also review the measure specifications, measure testing forms, and supplemental documents for the 5 episode-based cost measures:

Wave 5 cost measure development (2022-2023)

  • Wave 5 Public Comment Summary Report (PDF) describes input received during the Wave 5 pubic comment period on candidate measure areas, which was held from February 18, 2022 to April 1, 2022, and provides brief responses to feedback.
  • Summary of Wave 5 Workgroup Meeting (ZIP) contains a high-level summary of each of the measure-specific workgroup meetings held in in 7/2022. Workgroup members gave detailed input on each component of the cost measure, including:
    • Defining the episode group
    • Addressing patient sub-populations for meaningful clinical comparison
    • Assigning services to the episode group

Wave 1 cost measure comprehensive reevaluation (2022-2023)

Wave 4 cost measure development (2021-2022)

  • Wave 4 Public Comment Summary (PDF) describes input received during the Wave 4 public comment period on candidate measure areas, which was held from December 15, 2020 to February 5, 2021, and provides brief responses to feedback.
  • Summary of Wave 4 Workgroup meetings (ZIP) contains a high-level summary of each of the measure-specific workgroup meetings held in 6/2021. Workgroup members gave detailed input on each component of the cost measure, including:
    • Defining the episode group
    • Addressing patient sub-populations for meaningful clinical comparison
    • Assigning services to the episode group
  • Summary of Wave 4 Service Assignment & Refinement (SAR) Workgroup meetings (ZIP) contains a high-level summary of each of the measure-specific workgroup meetings held on 9/2021 and 10/2021. Workgroup members gave input on:
    • Assigning services to the episode group
    • Potential refinements to the measure specifications before national field testing
  • Summary of Wave 4 Post-Field Test Refinement Webinar (PFTR) Workgroup meetings (ZIP) contains a high-level summary of each of the measure-specific workgroup meetings held in 4/2022. Workgroup members gave input on:
    • Assigning services to the episode group
    • Potential refinements to the measure specifications after national field testing
  • Wave 4 Measure-Specific Workgroup Composition List (PDF) is the list of members of the measure-specific workgroups that met in 6/2021 to give detailed clinical input on the measure specifications for the 4 episode groups being developed in Wave 4.

Psychoses/Related Conditions cost measure refinement (2019-2022)

Chronic Kidney Disease/End-Stage Renal Disease (CKD/ESRD) cost measure development (2021-2022)

Learn about the cost measures & the development process

Content experts and other interested members of the public have had many opportunities to provide input throughout the process. Learn more about the MACRA cost measure development process from:

Please see below to learn about the cost measures developed in Wave 2:

Please see below to learn more about the cost measures developed in Wave 3:

Learn about the Care Episode & Patient Condition Codes

Prior feedback requests:

How can I learn about the Patient Relationship Categories & Codes?

  • Read more (PDF), based on your comments, about patient relationship categories and how we may use Current Procedural Terminology (CPT) Modifiers for reporting patient relationship codes.
  • View slides, transcripts, recordings and FAQs from the 2/21/18 and the 10/17/18 Patient Relationship Categories & Codes webinars.  
Page Last Modified:
09/21/2022 02:28 PM