QPP Measure #COST_PC_1
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 Prostate Cancer 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 and treat prostate cancer. This chronic condition measure includes the costs of services that are clinically related to the attributed clinician’s role in managing care during a Prostate Cancer episode.
The following codes apply for this QPP measure:
HCPCS Codes | |||
| Code | Description | ||
|---|---|---|---|
| M0001 | Advancing cancer care mips value pathways | ||
| M1423 | Optimal care for patients with urologic conditions mips value pathway | ||
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