MIPS Cost Performance Category
MIPS 2022
- 25 measures, including 15 episode-based measures, 6 acute-episode measures and 2 chronic care episode measures are automatically captured through claims data.
- Total Category Score is averaged from the score of all applicable measures.
- Measure performance is tracked over a full calendar year.
- Clinicians can preview 2018-2022 performance on a quarterly basis via MIPSpro Enterprise or through Healthmonix MIPS Cost Analytics .
Changes from 2021 MIPS Cost Reporting
- The Medicare Spending Per Beneficiary (MSPB) and Total Per Capita Cost (TPCC) measures were revised in 2020 and remain unchanged.
- Thirteen procedural episode measures remain part of the Cost performance category score. Two were added in 2022.
- Five acute episode measures remain, with one new measure introduced in 2022.
- Two new chronic care episode measures were added.
MIPS Cost Final Score
To calculate Cost, CMS will assign 1 to 10 achievement points to each scored measure shown in the table below, based on the clinician or group’s performance compared to the performance year benchmark. Therefore, achievement points for each measure depend on the decile range in which you or your group’s performance falls.
The maximum score for the category is 100%. Additional bonus points will not be applied to a perfect achievement score.
2022 MIPS Cost Measures
MEASURE TOPIC | MEASURE TYPE |
|---|---|
Medicare Spending Per Beneficiary (MSPB) | All patient |
Total Per Capita Costs (TPCC) | All patient |
Routine Cataract Removal with Intraocular Lens (IOL) Implantation Asthma/Chronic Obstructive Pulmonary Disease (COPD) | Procedural Chronic Condition |
Colon and Rectal Resection Diabetes Intracranial Hemorrhage or Cerebral Infarction | Procedural Chronic Condition Acute Inpatient Medical Condition |
Melanoma Resection Knee Arthroplasty | Procedural Procedural |
Elective Outpatient Percutaneous Coronary Intervention (PCI) | Procedural |
Simple Pneumonia with Hospitalization | Acute Inpatient Medical Condition |
Revascularization for Lower Extremity Chronic Critical Limb Ischemia | Procedural |
Screening/Surveillance Colonoscopy | Procedural |
ST-Elevation Myocardial Infarction (STEMI) with Percutaneous Coronary Intervention (PCI) Sepsis | Acute Inpatient Medical Condition Acute Inpatient Medical Condition |
Renal or Ureteral Stone Surgical Treatment | Procedural |
Non-Emergent Coronary Artery Bypass Graft (CABG) | Procedural |
Lumpectomy, Partial Mastectomy, Simple Mastectomy | Procedural |
Lower Gastrointestinal Hemorrhage Measure Cost Measure | Acute Inpatient Medical Condition |
Lumbar Spine Fusion for Degenerative Disease, 1-3 Levels | Procedural |
Inpatient Chronic Obstructive Pulmonary Disease (COPD) Exacerbation | Acute Inpatient Medical Condition |
Hemodialysis Access Creation | Procedural |
Femoral or Inguinal Hernia Repair | Procedural |
Elective Primary Hip Arthroplasty | Procedural |
Acute Kidney Injury Requiring New Inpatient Dialysis | Procedural |
key benefits
Healthmonix MIPS Cost Analytics are the next big thing in Cost tracking, optimization and revenue-generating insights.
See total Medicare spend, even outside of your network.
Access updated claims data quarterly.
Better impact your MIPS Cost score.
Learn how MIPS Cost Analytics can help you achieve your revenue goals and improve care.
Do you understand how CMS calculates Cost?
Check out our free, webinar: MIPS Cost Category - Back to the Basics to understand the basics of MIPS Cost reporting , learn how to to identify all Cost measures and prepare for 2022 Cost reporting.
Stay up to date with the latest news regarding MACRA and MIPS.
The Healthmonix Advisor is a free weekly news source, connecting you to the latest updates in the value-based care industry.