CMS Solicits Comments on Proposed MIPS Cost Measures

August 13, 2019


The Centers for Medicare and Medicaid Services (CMS) released the CY 2020 Proposed Rule for the Medicare Physician Fee Schedule (PFS). As part of the proposed rule, CMS is proposing 10 episode-based cost measures and revisions to the current Medicare Spending per Beneficiary (MSPB) and Total per Capita Cost (TCC) measures.

There is a public comment period currently open until September 27. Stakeholders can provide feedback on the proposed revisions to MSPB and TCC as well as the proposed ten cost measures:

  • Acute Kidney Injury Requiring New Inpatient Dialysis
  • Elective Primary Hip Arthroplasty
  • Femoral or Inguinal Hernia Repair
  • Hemodialysis Access Creation
  • Inpatient Chronic Obstructive Pulmonary Disease (COPD) Exacerbation
  • Lower Gastrointestinal Hemorrhage
  • Lumbar Spine Fusion for Degenerative Disease, 1-3 Levels
  • Lumpectomy, Partial Mastectomy, Simple Mastectomy
  • Non-Emergent Coronary Artery Bypass Graft (CABG)
  • Renal or Ureteral Stone Surgical Treatment

Additionally, CMS and Acumen, LLC will hold workgroup meetings for stakeholders interested in providing feedback during the development of potential additional episode-based cost measures for the Merit-based Incentive Payment System. Information about the meetings can be found here.


For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459 or

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