Total Per Capita Cost (TPCC)

The Total Per Capita Cost (TPCC) measure assesses the overall cost of care delivered to a beneficiary with a focus on the primary care they receive from their provider(s). The TPCC measure score is a clinician’s average risk-adjusted and specialty-adjusted cost across all beneficiary months attributed to the clinician during a one year performance period.

The measure is attributed to clinicians providing primary care management for the beneficiary, who are identified by their unique Taxpayer Identification Number and National Provider Identifier pair (TIN-NPI) and clinician groups, identified by their TIN number. Clinicians are attributed beneficiaries for one year, beginning from a combination of services indicate that a primary care relationship has begun. The resulting periods of attribution are then measured on a monthly level, assessing all Part A and Part B cost for the beneficiary for those months that occur during the performance period. The beneficiary populations eligible for the TPCC include Medicare beneficiaries enrolled in Medicare Parts A and B during the performance period.