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QPP Measure #COST_KTM_1

Kidney Transplant Management 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 D3 are used to construct this episode-based cost measure. The Kidney Transplant Management 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 related to kidney transplant, beginning 90 days post-transplant. This chronic condition measure includes the costs of services that are clinically related to the attributed clinician’s role in managing care during a Kidney Transplant Management 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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