Cost Scoring Logic

The Cost category has a weight of 30% in overall MIPS score.

New Measures Are Being Added and Modified

• CMS finalized a limited set of policy changes for 2026, including:
  A 2‑year informational‑only feedback period for new cost measures before they affect scoring.

6 episode-based cost measures are implemented at the group (TIN) and clinician (TIN/NPI) level with a 20- episode case minimum.

CMS retains the ability to suppress cost measures when reliability or specification issues arise.

CMS will calculate Cost category score based on administrative claims data. Individual MIPS eligible clinicians and groups don’t have to submit any other information for the Cost performance category.