Episodes and Clinical Chapters


Standardized Building Blocks for Transparency and Value

The current PACES episode catalogue consists of more than 1000 episode specifications covering nearly 90 percent of Medicare spending. An individual episode can represent an acute event, a chronic condition, or a procedure. The episodes are grouped into 15 Clinical Chapters or “Clusters” based upon their clinical domain. The episode examples posted here include relevant services, relevant diagnoses, sequelae and indications (for procedure episodes only). The clinical chapter documents posted below proivde a list of episodes within each chapter along with the trigger codes that open the episode.

The PACES Center plans to make a total of 57 episode examples available on this page between the fourth quarter of 2021 and the first quarter of 2022. These 57 episodes represent a significant portion of healthcare spending, including numerous CPT codes, DRGs and other services that are bundled together based on the PACES definitions and clinical logic.

Using the episode definitions, we are better able to represent the full end-to-end price for all the services consumed in a single episode so that patients have a better sense of what is involved in their complex medical care. Sign up for updates to be contacted when new episodes are posted and for other news.

Episode Examples

Episode Name Episode Type
Acute Myocardial InfarctionPDF Acute
Heart Failure (Acute)PDF Acute
Percutaneous Coronary InterventionPDF Procedure


PACES Clinical Chapters

Chapter Name Acute Events Conditions Procedure Families Grand Total
Behavioral Health 9 20 - 29
Blood 7 31 - 38
Cardiology 51 59 10 120
Circulatory 27 32 1 60
Dermatological 42 24 - 66
Endocrine 18 37 1 56
ENT 50 35 2 87
Eye 13 18 5 36
Gastrointestinal 51 74 13 138
Men's Health 15 16 - 31
Musculoskeletal 76 47 18 141
Neurological 30 55 1 86
Other 48 34 4 86
Urology/Renal 21 24 1 46
Women's Health 19 28 6 53
Total 477 534 62 1073