For the 2022 performance year, eligible clinicians and groups will receive a Cost performance category score that accounts for 30% of their final MIPS score. ECs and groups do not need to submit data or attest to anything for this category. Instead, CMS uses claims data to assess an individual or group's performance during the performance year.
Facility-based measurement scoring will be used for your quality and cost performance category scores when all the following conditions are met: 1.) You're identified as facility-based; and 2.) You're attributed to a facility with a FY 2023 Hospital Value-Based Purchasing (VBP) Program score. The MIPS quality and cost performance category scores will be based on the facility-based measurement scoring methodology unless a clinician or group receives a higher MIPS final score through another MIPS submission.
In 2022, CMS will use claims data to assess individual ECs and their groups on the cost measures below. Attribution of individual ECs or groups to these measures is often dependent upon the plurality of services and costs provided to individual patients for these measures. If an EC or group is unable to be scored in the Cost category, the 30% weighting will be redistributed to the Quality performance category (unless you are in a small group).
Population-based cost measures:
Procedural episode-based cost measures:
Acute inpatient medical condition episode-based cost measures:
Chronic condition episode-based
Cost measure specifications and regulatory information are available on the Quality Payment Program Resource Library website. ASA continues to advocate for physician anesthesiologists to be fairly and accurately assessed under the MIPS cost category.