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

QPP Measure #COST_ESRD_1

End-Stage Renal Disease (ESRD) episode-based cost measure

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 ESRD episode-based cost measure evaluates a clinician’s or clinician group’s risk-adjusted and specialty-adjusted cost to Medicare for patients who receive medical care to manage ESRD. This chronic condition measure includes the costs of services that are clinically related to the attributed clinician’s role in managing care during an ESRD episode.

Submission Methods: Administrative Claims

The following codes apply for this QPP measure:

HCPCS Codes

CodeDescription
M0002Optimal care for kidney health mips value pathways
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