MIPS Cost Performance Category

30% of your MIPS Performance Score

Our system captures 25 essential measures from claims data, including 15 episode-based measures, 6 acute-episode measures, and 2 chronic care episode measures.

Track your MIPS Cost performance over a full calendar year with our system's Total Category Score calculation, which averages the score of all applicable measures

Stay ahead of the curve with quarterly performance previews through MIPSpro Enterprise or Healthmonix MIPS Cost Analytics.

Need to know for 2023
MIPS Cost Reporting

  • If a clinician or group does not meet the minimum number of cases for any of the cost measures, the cost category will be re-weighted.
  • The most common applicable cost measures are Total Per Capita Cost (TPCC) and Medicare Spending Per Beneficiary (MSPB).
  • CMS calculates a single, national benchmark for each cost measure based on the performance year. All MIPS-eligible clinicians who meet or exceed the minimum number of cases for a measure are included in the same benchmark.
  • Cost Performance is 30% of your final score

Use the dropdown menu below to view Cost measures & Specs

2023 MIPS Cost Measures

Measure Topic

Measure Type

Specs

Medicare Spending Per Beneficiary (MSPB)

All Patient

PDF

Code list

Total Per Capita Costs (TPCC)

All Patient

PDF

Code list

Routine Cataract Removal with Intraocular Lens (IOL) Implantation

Procedural

PDF

Code list

Asthma/Chronic Obstructive
Pulmonary Disease (COPD)

Chronic Condition

PDF

Code list

Colon and Rectal Resection 

Procedural

PDF

Code list

Diabetes

Chronic Condition

PDF

Codes list

Intracranial Hemorrhage or Cerebral Infraction

Acute Inpatient Medical Condition

PDF

Codes list

Melanoma Resection

Procedural

PDF

Code list

Knee Arthroplasty

Procedural

PDF

Code list

Elective Outpatient Percutaneous
Coronary Intervention (PCI)

Procedural

PDF

Code list

Simple Pneumonia with Hospitalization

Acute Inpatient Medical Condition

PDF

Code list

Revascularization for Lower Extremity
Chronic Critical Limb Ischemia

Procedural

PDF

Code list

Screening/Surveillance Colonoscopy

Procedural

PDF

Code list

ST-Elevation Myocardial Infarction (STEMI)
with Percutaneous Coronary Intervention (PCI)

Acute Inpatient Medical Condition

PDF

Code list

Sepsis

Acute Inpatient Medical Condition

PDF

Code list

Renal or Ureteral Stone Surgical Treatment

Procedural

PDF

Code list

Non-Emergent Coronary
Artery Bypass Graft (CABG)

Procedural

PDF

Code list

Lumpectomy, Partial Mastectomy,
Simple Mastectomy

Procedural

PDF

Code list

Lower Gastrointestinal Hemorrhage 

Acute Inpatient Medical Condition

PDF

Code list

Lumbar Spine Fusion for
Degenerative Disease, 1-3 Levels

Procedural

PDF

Code list

Inpatient Chronic Obstructive
Pulmonary Disease (COPD) Exacerbation

Acute Inpatient Medical Condition

PDF

Code list

Hemodialysis Access Creation

Procedural

PDF

Code list

Femoral or Inguinal Hernia Repair

Procedural

PDF

Code list

Elective Primary Hip Arthroplasty

Procedural

PDF

Code list

Acute Kidney Injury Requiring
New Inpatient Dialysis

Procedural

PDF

Code list

MIPS Cost Analytics is the next big thing in Cost tracking. 

Learn how we can help you achieve your revenue goals and improve care.

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