About cost measures & development process

Episode-based cost measures are developed and maintained in iterative processes involving in-depth input from content experts and the public. Learn more about cost measures and the measure development process from:

2026 MIPS cost performance category resources

• 2026 Cost Measure Information Forms (ZIP) detail the cost measure methodology for each of the 33 episode-based cost measures, the Medicare Spending Per Beneficiary (MSPB) Clinician measure, and the Total Per Capita Cost (TPCC) measure that are in use for the cost performance category in 2026.
• 2026 Cost Measure Codes Lists (ZIP) detail the cost measure codes list for each of the 33 episode-based cost measures, the MSPB Clinician measure, and the TPCC measure that are in use for the cost performance category in 2026.
• 2026 MIPS Summary of Cost Measures (PDF) provides a summary of cost measures in use for MIPS in 2026 as well as measures under development. 

Care episode & patient condition codes

• 2026 Operational List of Care Episode & Patient Condition Codes (XLSX) includes revisions as finalized in the CY 2026 Physician Fee Schedule final rule to reflect service and diagnosis code updates identified through the annual maintenance of cost measures.
• Prior operational lists (ZIP) contains operational lists of care episode & patient condition codes posted in 2018, 2020, 2021, 2022, 2023, and 2024.

General information about cost measures 

• Shared Data Across Cost Measurements (PDF) shows how claims data is shared within and across cost measures and is intended to address questions about "double counting."
• Chronic Condition Cost Measure Framework poster (PDF) provides information on the chronic condition episode-based cost measure framework and describes how the framework captures the costs of care to meet the MACRA mandate.
• MIPS Chronic Condition Episode-Based Cost Measures Attribution Methodology (ZIP) contains a one-pager and the Frequently Asked Questions (FAQ) document describing the attribution methodology used for chronic condition episode-based cost measures.
• Methodology for Incorporation of Rebates in Part D Standardized Amounts (PDF) provides information on how the Part D standardization methodology incorporates rebates into standardized amounts.
• 2022-2024 MIPS Cost Measures FAQ (PDF) answers key questions about MIPS cost measures in use for the 2022, 2023, and 2024 performance periods.

About the measure development process

• Input Opportunities (PDF) lists many ways to participate in the development process.
• Person & Family Committee Guiding Principles (PDF) shows high-level guiding principles developed from structured patient and caregiver interviews to inform cost measure development.