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 Infarction	Acute
Heart Failure (Acute)	Acute
Percutaneous Coronary Intervention	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