Year:  2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 

QPP Measure #COST_D_1

Diabetes

Episode-based cost measures represent the cost to Medicare for the items and services provided to a patient during an episode of care ("episode"). In all supplemental documentation, the term "cost" generally means the standardized Medicare allowed amount, and claims data from Medicare Parts A, B, and D are used to construct this episode-based cost measure. The Diabetes episode-based cost measure evaluates a clinician's or clinician group's risk-adjusted cost to Medicare for patients receiving medical care to manage and treat diabetes. This chronic condition measure includes the costs of services that are clinically related to the attributed clinician's role in managing care during a Diabetes episode.

Submission Methods: Administrative Claims

The following codes apply for this QPP measure:

HCPCS Codes

CodeDescription
M0005Value in primary care mips value pathway
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