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Hospital-level, risk-standardized payment associated with a 30-day episode of care for pneumonia (PN)

CBE ID
2579
1.4 Project
Endorsed
Endorsement Status
1.1 New or Maintenance
E&M Cycle
Is Under Review
No
Next Planned Maintenance Review
Cost and Efficiency Spring 2025
1.3 Measure Description

This measure estimates hospital-level, risk-standardized payment for an eligible pneumonia episode of care starting with inpatient admission to a short term acute-care facility and extending 30 days post-admission for Medicare fee-for-service (FFS) patients who are 65 years or older with a principal discharge diagnosis of pneumonia or principal discharge diagnosis of sepsis (not including severe sepsis) that have a secondary discharge diagnosis of pneumonia coded as present on admission (POA) and no secondary diagnosis of severe sepsis coded as POA.