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Explore Measures & Activities

How to Use This Tool

This tool has been created to help you get familiar with the different measures you can submit and prepare for the year. It's for planning purposes only and will not submit anything to CMS. To get the most out of the tool, follow the steps below:

  1. Explore (Search, browse, or filter) available measures
  2. Add measures you're interested in to your list
  3. Download your list of interested measures for reference

Performance Year

Select your performance year to view across all tabs.

2019 Cost Measures

15% of final score

This percentage can change if the measures' minimum case volumes are not met. If there are not enough attributed cases for any of the 10 measures to be scored, the Cost performance category percentage will be added to the Quality performance category. 

There is no data submission requirement for the Cost performance category. Cost measures are evaluated automatically through administrative claims data.

Read more about Cost requirements

10 Cost Measures
  • Elective Outpatient Percutaneous Coronary Intervention (PCI)

    A clinician’s risk-adjusted cost to Medicare for beneficiaries who undergo elective outpatient PCI surgery to place a coronary stent for heart disease during the performance period. Includes costs of services clinically related to the attributed clinician’s role in managing care from the PCI surgery that triggers the episode through 30 days after the trigger.

    Collection Type

    • Administrative claims measures

    Measure ID

    COST_EOPCI_1

  • Intracranial Hemorrhage or Cerebral Infarction

    A clinician’s risk-adjusted cost to Medicare for beneficiaries hospitalized for cerebral infarction or intracranial hemorrhage during the performance period. Includes costs of services clinically related to the attributed clinician’s role in managing care from the inpatient hospitalization that triggers the episode through 90 days after the trigger.

    Collection Type

    • Administrative claims measures

    Measure ID

    COST_IHCI_1

  • Knee Arthroplasty

    A clinician’s risk-adjusted cost to Medicare for beneficiaries who undergo an elective knee arthroplasty during the performance period. Includes costs of services clinically related to the attributed clinician’s role in managing care from 30 days prior to the knee arthroplasty that triggers the episode through 90 days after the trigger.

    Collection Type

    • Administrative claims measures

    Measure ID

    COST_KA_1

  • Medicare Spending Per Beneficiary (MSPB)

    The risk-adjusted cost to Medicare for all Parts A and B services performed for an inpatient beneficiary as a result of a clinician’s care during the period 3 days prior to the patient’s hospital stay through 30 days after discharge.

    Collection Type

    • Administrative claims measures

    Measure ID

    MSPB_1

  • Revascularization for Lower Extremity Chronic Critical Limb Ischemia

    A clinician’s risk-adjusted cost to Medicare for beneficiaries who undergo elective revascularization surgery for lower extremity chronic critical limb ischemia during the performance period. Includes costs of services that are clinically related to the attributed clinician’s role in managing care from 30 days prior to the revascularization procedure that triggers the episode through 90 days after the trigger.

    Collection Type

    • Administrative claims measures

    Measure ID

    COST_CCLI_1

  • Routine Cataract Removal with Intraocular Lens (IOL) Implantation

    A clinician’s risk-adjusted cost to Medicare for beneficiaries who undergo a procedure for routine cataract removal with IOL implantation during the performance period. Includes costs of services that are clinically related to the attributed clinician’s role in managing care from 60 days prior to the cataract removal procedure that triggers the episode through 90 days after the trigger.

    Collection Type

    • Administrative claims measures

    Measure ID

    COST_IOL_1

  • Screening/Surveillance Colonoscopy

    A clinician’s risk-adjusted cost to Medicare for beneficiaries who receive a screening/surveillance colonoscopy. Includes costs of services that are clinically related to the attributed clinician’s role in managing care from the screening/surveillance colonoscopy procedure that triggers the episode through 14 days after the trigger.

    Collection Type

    • Administrative claims measures

    Measure ID

    COST_SSC_1

  • Simple Pneumonia with Hospitalization

    A clinician’s risk-adjusted cost to Medicare for beneficiaries hospitalized with simple pneumonia during the performance period. Includes costs of services that are clinically related to the attributed clinician’s role in managing care from the inpatient hospitalization that triggers the episode through 30 days after the trigger.

    Collection Type

    • Administrative claims measures

    Measure ID

    COST_SPH_1

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

    A clinician’s risk-adjusted cost to Medicare for beneficiaries who present with STEMI, indicating complete blockage of a coronary artery, who emergently receive PCI as treatment during the performance period. Includes costs of services that are clinically related to the attributed clinician’s role in managing care from the inpatient hospitalization that triggers the episode through 30 days after the trigger.

    Collection Type

    • Administrative claims measures

    Measure ID

    COST_STEMI_1

  • Total Per Capita Costs (TPCC)

    The overall, payment-standardized, annualized, risk-adjusted, and specialty-adjusted cost of care provided to beneficiaries attributed to their primary care clinicians.

    Collection Type

    • Administrative claims measures

    Measure ID

    TPCC_1