2020 MIPS Cost Performance Category
- Measure performance is tracked over a full year.
- 10 new episode-based measures added which revise the Medicare Spending per Beneficiary Clinician and Total Per Capita Cost measures.
- Clinicians can preview 2018-2020 performance on a quarterly basis via MIPSpro Enterprise or through MIPS Cost Analytics packages.
- Total Category Score is averaged from the score of all applicable measures.
Key changed from 2019 cost reporting
- There has been no change from payment year 2019. Cost has a 15% weight and Quality has a 45% weight in the overall MIPS performance score.
- 10 new episode-based measures are now part of the Cost performance category score.
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 which decile range you or your group’s performance falls in.
The maximum score for the category is 100%. Additional bonus points will not be applied to a perfect achievement score.
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 | Procedural |
Intracranial Hemorrhage or Cerebral Infarction | Acute Inpatient Medical Condition |
Knee Arthroplasty | 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) | 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
MIPS Cost Analytics is 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 every 90 days, instead of 18 months after-the-fact.
Better impact your MIPS Cost score.
Contact us today to learn how MIPS Cost Analytics can help you achieve your revenue goals and improve care.
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