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 provide 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 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|