Emergency Department measures

The following tables list all the measures currently available in Clinical Analytics for Emergency Department Encounters (ED).

In these tables, the following appear:

Short Description of the measure (what the measure is called in Clinical Analytics)
Long Description (to help you understand what the measure is for)
Polarity (if high or low values are preferred)
If All Payer and/or MedPar Benchmarks are currently available for the measure
Benchmark calculation level (that is, if the benchmark values are based on the DRG grouping of the encounter, or if they are facility-level).

Click here to download this measure list as a PDF: ED Measures (December 2019)

Click here to download all measure lists as a single PDF: Comprehensive Clinical Analytics measure list

ED Comorbidity measures

These measures help identify patients with additional health factors; encounters are flagged by the AHRQ grouper software. All comorbidity measures have undeterminable polarity.

Measure name	Description	Polarity	All Payer benchmarks?	Medicare benchmarks?	Benchmark detail level
Heart Attack Case	Number of cases with at least one secondary diagnosis for a heart attack	N/A	Yes	Yes	Provider
Heart Failure Case	Number of cases with at least one secondary diagnosis for heart failure	N/A	Yes	Yes	Provider
Pneumonia Case	Number of cases with at least one Secondary Diagnosis for pneumonia	N/A	Yes	Yes	Provider
Septicemia Case	Number of cases with at least one Secondary Diagnosis for septicemia	N/A	Yes	Yes	Provider
Stroke Case	Number of cases with at least one Secondary Diagnosis for a stroke	N/A	Yes	Yes	Provider
VTE Case	Number of cases with at least one Secondary Diagnosis for a venous thromboembolism	N/A	No	Yes	APC

ED Knowledge measures

These measures help monitor the usage levels of certain services. Low values are desirable for all Knowledge measures.

Measure name	Description	Polarity	All Payer benchmarks?	Medicare benchmarks?	Benchmark detail level
Usage - Blood Use	Percent of patients with Blood Use Revenue codes: 0380-0387, 0389-0391, 0399	Low	No	Yes	APC
Usage - CT Use	Percent of patients with CT Use Revenue codes: 035X	Low	No	Yes	APC
Usage - MRI Use	Percent of patients with MRI Use Revenue codes: 0610-0612, 0614-0616, 0618, 0619	Low	No	Yes	APC
Usage - Occupational Therapy Use	Percent of patients with Occupational Therapy charges Revenue codes: 0430-0434, 0439	Low	No	No	APR-DRG/SOI or MS-DRG
Usage - Physical Therapy Use	Percent of patients with Physical Therapy charges Revenue codes: 0420-0424, 0429	Low	No	No	APR-DRG/SOI or MS-DRG
Usage - Respiratory Therapy Use	Percent of patients with Respiratory Therapy charges Revenue codes: 0410, 0412, 0413, 0419	Low	No	No	APR-DRG/SOI or MS-DRG
Usage - Speech Therapy Use	Percent of patients with Speech Therapy charges Revenue codes: 0440-0444, 0449, 0470-0472, 0479	Low	No	No	APR-DRG/SOI or MS-DRG
Usage - PT, OT and Speech Therapy Use	Percent of patients with at least one revenue code for Physical Therapy, Occupational Therapy, or Speech Therapy Revenue codes: 0420-0424, 0429-0434, 0439-0444, 0449	Low	No	Yes	APC
Usage - Radiology Use	Percent of patients with Radiology Use Revenue codes: 0320-0324, 0329, 0330, 0339-0342, 0349-0352, 0359, 0400-0404, 0409	Low	No	Yes	APC

ED Quality measures

These measures help you track typical patient outcomes, such as readmissions and mortality, as well as core measures data from your third-party vendor.

Measure name	Description	Polarity	All Payer benchmarks?	Medicare benchmarks?	Benchmark detail level
Mortality Rate	Number of deaths in-house divided by number of patients	Low	No	No	N/A
Mortality without Palliative Rate	Number of in-house deaths (excluding deaths of patients with palliative care) divided by number of patients	Low	No	No	N/A
Mortality Rate (with Exclusions)	Number of deaths in-house divided by number of patients; numerator and denominator also exclude patients transferred in (4, A), transferred out (2, 5, 43, 82), or discharged Against Medical Advice (AMA: 7).	Low	Yes	Yes	APR-DRG/ROM or MS-DRG
Mortality without Palliative Rate (with Exclusions)	Number of in-house deaths (excluding deaths of patients with palliative care) divided by number of patients; numerator and denominator also exclude patients transferred in (4, A), transferred out (2, 5, 43, 82), or discharged Against Medical Advice (AMA: 7).	Low	Yes	Yes	APR-DRG/ROM or MS-DRG
OP - 8 MRI Lumbar Spine for Low Back Pain	Percentage of MRI (Magnetic Resonance Imaging) of the Lumbar Spine studies with a diagnosis of low back pain on the imaging claim and for which the patient did not have prior claims-based evidence of antecedent conservative therapy See the QualityNet website for more information.	High	No	No	N/A
OP - 9 Mammography Follow-Up Rates	Percentage of patients with mammography screening studies that are followed by a diagnostic mammography, ultrasound, or Magnetic Resonance Imaging (MRI) of the breast in an outpatient or office setting within 45 days See the QualityNet website for more information.	High	No	No	N/A
OP - 10 Abdomen CT Use of Contrast Material	Percentage of abdomen studies that are performed with and without contrast out of all abdomen studies performed (those with contrast, those without contrast, and those with both) See the QualityNet website for more information.	High	No	No	N/A
OP - 11 Thorax CT - Use of Contrast Material	Percentage of thorax studies that are performed with and without contrast out of all thorax studies performed (those with contrast, those without contrast, and those with both) See the QualityNet website for more information.	High	No	No	N/A
OP - 12 The Ability for Providers with HIT to Receive Laboratory Data Electronically Directly into their ONC-Certified EHR System as Discrete Searchable Data	The extent to which a provider uses an Office of the National Coordinator for Health Information Technology (ONC) certified electronic health record (EHR) system that incorporates an electronic data interchange with one or more laboratories allowing for direct electronic transmission of laboratory data in the EHR as discrete searchable data elements See the QualityNet website for more information.	High	No	No	N/A
OP - 13 Cardiac Imaging for Preoperative Risk Assessment for Non-Cardiac Low-Risk Surgery	Percentage of Stress Echocardiography, Single Photon Emission Computed Tomography, Myocardial Perfusion Imaging (SPECT MPI), Cardiac Computed Tomography Angiography (CCTA), or Stress Magnetic Resonance Imaging (MRI) studies performed at a hospital outpatient facility in the 30 days prior to an ambulatory low-risk, non-cardiac surgery performed anywhere See the QualityNet website for more information.	High	No	No	N/A
OP - 14 Simultaneous Use of Brain Computed Tomography (CT) and Sinus CT	Percentage of Brain CT studies with a simultaneous Sinus CT (for example, Brain and Sinus CT studies performed on the same day at the same facility) See the QualityNet website for more information.	High	No	No	N/A
OP-15 Use of Brain Computed Tomography (CT) in the ED for Atraumatic Headache	Percent of ED patients with atraumatic headache who are given a brain CT This measure was discontinued by CMS as of January 1, 2017	High	No	No	N/A
OP - 17 Tracking Clinical Results between Visits	The extent to which a provider uses an Office of the National Coordinator for Health Information Technology (ONC) certified electronic health record (EHR) system to track pending laboratory tests, diagnostic studies (including common preventive screenings), or patient referrals See the QualityNet website for more information.	High	No	No	N/A
OP-18a Median Time from ED Arrival to ED Departure for Discharged ED Patients - Overall Rate	Median time from emergency department arrival to time of departure from the emergency room for patients discharged from the emergency department See the QualityNet website for more information.	Low	No	No	N/A
OP-18b Median Time from ED Arrival to ED Departure for Discharged ED Patients - Reporting Measure	Median time from emergency department arrival to time of departure from the emergency room for patients discharged from the emergency department See the QualityNet website for more information.	Low	No	No	N/A
OP-18c Median Time from ED Arrival to ED Departure for Discharged ED Patients - Psychiatric/Mental Health Patients	Median time from emergency department arrival to time of departure from the emergency room for patients discharged from the emergency department See the QualityNet website for more information.	Low	No	No	N/A
OP-18d Median Time from ED Arrival to ED Departure for Discharged ED Patients - Transfer Patients	Median time from emergency department arrival to time of departure from the emergency room for patients discharged from the emergency department See the QualityNet website for more information.	Low	No	No	N/A
OP-20 Door to Diagnostic Evaluation by a Qualified Medical Personnel	Median time from ED arrival to provider contact for Emergency Department patients See the QualityNet website for more information.	Low	No	No	N/A
OP-21 Median Time to Pain Management for Long Bone Fracture	Median time, in minutes, from emergency department arrival to time of initial oral, intranasal, or parenteral pain medication administration for emergency department patients with a principal diagnosis of long bone fracture	Low	No	No	N/A
OP-22 Left Without Being Seen	Percent of patients who leave the Emergency Department (ED) without being evaluated by a physician/advanced practice nurse/physician’s assistant (physician/APN/PA) See the QualityNet website for more information.	Low	No	No	N/A
OP-23 Head CT or MRI Scan Results for Acute Ischemic Stroke or Hemorrhagic Stroke Patients who Received Head CT or MRI Scan Interpretation Within 45 Minutes of ED Arrival	Emergency Department Acute Ischemic Stroke or Hemorrhagic Stroke patients who arrive at the ED within 2 hours of the onset of symptoms who have a head CT or MRI scan performed during the stay and having a time from ED arrival to interpretation of the Head CT or MRI scan within 45 minutes of arrival.	Low	No	No	N/A
Rhogam for Rh-neg pregnant women	Percentage of Rh-negative pregnant women aged 14-50 years at risk of fetal blood exposure who receive Rh-Immunoglobulin (Rhogam) in the emergency department (ED); MIPS measure #255	Low	No	No	N/A
Ultrasound for pregnant abdominal pain (PQRS 254, NQF 0651)	Percentage of pregnant female patients aged 14 to 50 who present to the emergency department (ED) with a chief complaint of abdominal pain or vaginal bleeding who receive a trans-abdominal or trans-vaginal ultrasound to determine pregnancy location; MIPS measure #254	Low	No	No	N/A
Systemic Antimicrobial Therapy for AOE (PQRS 93, NQF 0653)	Percentage of patients aged 2 years and older with a diagnosis of Acute Otitis Externa (AOE) who were not prescribed systemic antimicrobial therapy; this is for avoidance of inappropriate use NOTE: This measure was discontinued in 2016 and is not recommended for more recent data.	Low	No	No	N/A
Topical preparations for AOE (PQRS 91, NQF 0653)	Percentage of patients aged 2 years and older with a diagnosis of AOE who were prescribed topical preparations NOTE: This measure was discontinued in 2016 and is not recommended for more recent data.	Low	No	No	N/A
ECG for syncope (PQR 55, NQF 0093)	Percentage of patients aged 60 years and older with an ED discharge diagnosis of syncope who had a 12-lead ECG performed NOTE: This measure was discontinued in 2016 and is not recommended for more recent data.	High	No	Yes	APC
ECG for non-traumatic chest pain (PQRS 54, NQF 0090)	Percentage of patients aged 40 years and older with an ED discharge diagnosis of non-traumatic chest pain who had a 12-lead ECG performed NOTE: This measure was discontinued in 2016 and is not recommended for more recent data.	High	No	Yes	APC
ED return (w/in 48 hours)	Percentage of ED discharges returning to the ED within 2 days of discharge NOTE: This measure was discontinued in 2016 and is not recommended for more recent data.	Low	No	No	APC
Patient Returns measures
Hours to Return (Any Patient Type)	Average number of hours from patient discharge date/time to subsequent admit date/time. NOTE: The return encounter can be for any patient type.	High	No	No	N/A
Patient returns within 24 hours (Any Patient Type)	Percent of patients who were re-admitted as any patient type within 24 hours of discharge.	Low	No	No	N/A
Patient returns within 48 hours (Any Patient Type)	Percent of patients who were re-admitted as any patient type within 48 hours of discharge.	Low	No	No	N/A
Days to Return (Any Patient Type) - Decimal	Average number of days from patient discharge date/time to subsequent admit date/time. NOTE: The return encounter can be for any patient type.	High	No	No	N/A
Patient returns within 7 days (Any Patient Type)	Percent of patients who were re-admitted as any patient type within 7 days of discharge.	Low	No	No	N/A
Patient returns within 14 days (Any Patient Type)	Percent of patients who were re-admitted as any patient type within 14 days of discharge.	Low	No	No	N/A
Patient returns within 30 days (Any Patient Type)	Percent of patients who were re-admitted as any patient type within 30 days of discharge.	Low	No	No	N/A
Returns to ED measures
Hours to Return to ED	Average number of hours from patient discharge date/time to subsequent Emergency Department admit date/time.	High	No	No	N/A
Patient returns to ED within 24 hours	Percent of patients who were re-admitted to the Emergency Department within 24 hours of discharge.	Low	No	No	N/A
Patient returns to ED within 48 hours	Percent of patients who were re-admitted to the Emergency Department within 48 hours of discharge.	Low	No	No	N/A
Days to Return to ED - Decimal	Average number of days from patient discharge date/time to subsequent Emergency Department admit date/time.	High	No	No	N/A
Patient returns to ED within 7 days	Percent of patients who were re-admitted to the Emergency Department within 7 days of discharge.	Low	No	No	N/A
Patient returns to ED within 14 days	Percent of patients who were re-admitted to the Emergency Department within 14 days of discharge.	Low	No	No	N/A
Patient returns to ED within 30 days	Percent of patients who were re-admitted to the Emergency Department within 30 days of discharge.	Low	No	No	N/A
Returns to Surgery measures
Hours to Return to Surgery	Average number of hours from patient discharge date/time to subsequent surgery encounter admit date/time. NOTE: The returns include inpatient encounters with a surgical MS-DRG and ASC (outpatient ambulatory surgery) encounters.	High	No	No	N/A
Patient returns to Surgery within 24 hours	Percent of patients who were re-admitted as a surgical patient within 24 hours of discharge. NOTE: The returns include inpatient encounters with a surgical MS-DRG and ASC (outpatient ambulatory surgery) encounters.	Low	No	No	N/A
Patient returns to Surgery within 48 hours	Percent of patients who were re-admitted as a surgical patient within 48 hours of discharge. NOTE: The returns include inpatient encounters with a surgical MS-DRG and ASC (outpatient ambulatory surgery) encounters.	Low	No	No	N/A
Days to Return to Surgery - Decimal	Average number of days from patient discharge date/time to subsequent surgery encounter admit date/time. NOTE: The returns include inpatient encounters with a surgical MS-DRG and ASC (outpatient ambulatory surgery) encounters.	High	No	No	N/A
Patient returns to Surgery within 7 days	Percent of patients who were re-admitted as a surgical patient within 7 days of discharge. NOTE: The returns include inpatient encounters with a surgical MS-DRG and ASC (outpatient ambulatory surgery) encounters.	Low	No	No	N/A
Patient returns to Surgery within 14 days	Percent of patients who were re-admitted as a surgical patient within 14 days of discharge. NOTE: The returns include inpatient encounters with a surgical MS-DRG and ASC (outpatient ambulatory surgery) encounters.	Low	No	No	N/A
Patient returns to Surgery within 30 days	Percent of patients who were re-admitted as a surgical patient within 30 days of discharge. NOTE: The returns include inpatient encounters with a surgical MS-DRG and ASC (outpatient ambulatory surgery) encounters.	Low	No	No	N/A

ED Systems measures

These measures are summary statistics of your patient populations, like gender and admission source.

Measure name	Description	Polarity	All Payer benchmarks?	Medicare benchmarks?	Benchmark detail level
Number of ED Arrivals	Volume of ED encounters	N/A	No	Yes	APC
Volume	Count of inpatient discharges	High	No	No	N/A
Gender - Female	Number of female patients divided by the total number of discharges	N/A	No	No	N/A
Gender - Male	Number of male patients divided by the total number of discharges	N/A	No	No	N/A
Discharge Disposition measures
% of ED patients transferred to another facility	Number of ED encounters transferred to another facility (Discharge Disposition=2, 65 or 66) divided by the number of ED encounter discharges	N/A	No	Yes	APC
% ED patients admitted as inpatient	Number of ED encounters admitted to the facility as an inpatient (based on Patient Admitted Indicator flag) divided by the number of ED encounter discharges	N/A	No	Yes	APC
% Admitted As an Inpatient to This Hospital	Percent of outpatient encounters admitted as an inpatient to this hospital: Number of encounters with Discharge Disposition=9 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged To Home / Self Care (Routine Discharge)	Percent of patients discharged to home or self-care (routine discharge): Number of encounters with Discharge Disposition=1 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred / Referred To another Institution for Outpatient Services	Percent of patients discharged, transferred, or referred to another institution for outpatient services: Number of encounters with Discharge Disposition=71 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred / Referred To This Institution for Outpatient Services	Percent of patients discharged, transferred, or referred to this institution for outpatient services: Number of encounters with Discharge Disposition=72 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred To Home Care	Percent of patients discharged or transferred to Home Care: Number of encounters with Discharge Disposition=6 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred To a Long Term Care	Percent of patients discharged or transferred to a long-term care facility: Number of encounters with Discharge Disposition=63 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred To a Nursing Facility	Percent of patients discharged or transferred to a nursing facility: Number of encounters with Discharge Disposition=64 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred To an Inpatient Rehabilitation Facility	Percent of patients discharged or transferred to an inpatient rehabilitation facility: Number of encounters with Discharge Disposition=62 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred To another Type of Institution for Inpatient Care	Percent of patients discharged or transferred to another type of institution for inpatient care: Number of encounters with Discharge Disposition=5 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred To Home under Care of a Home IV Drug Therapy Provider	Percent of patients discharged or transferred to home under care of a home iv drug therapy provider: Number of encounters with Discharge Disposition=8 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred To Intermediate Care Facility	Percent of patients discharged or transferred to intermediate care facility: Number of encounters with Discharge Disposition=4 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred To Other Short Term General Hospital for Inpatient Care	Percent of patients discharged or transferred to other short-term general hospital for inpatient care: Number of encounters with Discharge Disposition=2 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred To Skilled Nursing Facility (SNF)	Percent of patients discharged or transferred to skilled nursing facility (SNF): Number of encounters with Discharge Disposition=3 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged / Transferred Within This Institution to a Hospital-Based Medicare Approved Swing Bed	Percent of patients discharged or transferred within this institution to a hospital-based Medicare-approved swing bed: Number of encounters with Discharge Disposition=61 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged/transferred to a Critical Access Hospital (CAH)	Percent of patients discharged or transferred to a critical access hospital (CAH): Number of encounters with Discharge Disposition=66 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged/transferred to a federal hospital	Percent of patients discharged or transferred to a federal hospital: Number of encounters with Discharge Disposition=43 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Discharged/Transferred to a psychiatric hospital or psychiatric distinct unit of a hospital	Percent of patients discharged or transferred to a psychiatric hospital or psychiatric distinct unit of a hospital: Number of encounters with Discharge Disposition=65 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Expired - At Home (Hospice Claims Only)	Percent of patients discharged expired - at home (hospice claims only): Number of encounters with Discharge Disposition=40 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Expired - Did Not Recover (Christian Science Patient)	Percent of patients discharged expired (or "did not recover" for Christian Science patients): Number of encounters with Discharge Disposition=20 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Expired - In a Medical Facility Such as Hospital, SNF, ICF, or Freestanding Hospice	Percent of patients discharged expired from a medical facility such as hospital, SNF, ICF, or freestanding hospice: Number of encounters with Discharge Disposition=41 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Expired - Place Unknown (Hospice Claims Only)	Percent of patients discharged expired - place unknown (hospice claims only): Number of encounters with Discharge Disposition=42 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Hospice - Home	Percent of patients discharged to hospice - home: Number of encounters with Discharge Disposition=50 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Hospice - Medical Facility	Percent of patients discharged to hospice - medical facility: Number of encounters with Discharge Disposition=51 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Left Against Medical Advice or Discontinued Care	Percent of patients who left against medical advice (AMA) or discontinued care: Number of encounters with Discharge Disposition=7 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG
% Still Patient	Percent of patients who are still a patient: Number of encounters with Discharge Disposition=30 divided by the total number of discharges	N/A	Yes	Yes	APR-DRG/SOI or MS-DRG

ED Throughput measures

These measures help you track encounter times through your Emergency Department. Timestamp data are required for these measures.

Measure name	Description	Polarity	All Payer benchmarks?	Medicare benchmarks?	Benchmark detail level
ED waiting time	Median time, in minutes, between when patients arrive at the Emergency Department and when the patient is placed in an ED bed	Low	No	Yes	APC
Triage Time to First Provider Contact Time	Median time, in minutes, between when the patient's triage is finished and the first provider contact time	Low	No	Yes	APC
Excessive Boarding Times	Median time, in minutes, between the decision to admit the patient and when the patient departs the ED	Low	No	Yes	APC
Admitted/transferred ED patient with LOS >= 6 hours	Percent of patients admitted to the facility or transferred to another facility whose length of ED visit was greater than or equal to 6 hours	Low	No	Yes	APC
Total ED Time	Median time, in minutes, a patient spends in the Emergency Department, from arrival to departure	Low	No	Yes	APC
ED Treatment Time	Median time, in minutes, between when the patient is placed in an ED bed and when the patient is discharged	Low	No	Yes	APC
ED Decision to Discharge Time	Median time, in minutes, between when the decision is made to discharge the patient and when the patient is actually discharged	Low	No	Yes	APC
Hours to Return ED Visit	Number of hours between the discharge time for an encounter and the admit time for the next ED arrival time	Low	No	Yes	APC

ED Utilization measures

These measures help you analyze patient days, LOS, and costs/charges throughout your facility.

Measure name	Description	Polarity	All Payer benchmarks?	Medicare benchmarks?	Benchmark detail level
Observation Hours	Average number of observation days per patient Revenue Codes: 0762, 0760	Low	No	No	N/A
Patient Stayed Two Midnights	Flag of 0 or 1, where 1 indicates that a given encounter was discharged at least two midnights after admission	Low	No	Yes	APC
ED Acuity Level measures
% of ED patients with Acuity Level 5	Number of ED patients with an Acuity Level of 5 divided by the total number of ED discharges	N/A	No	Yes	APC
% of ED patients with Acuity Level 4	Number of ED patients with an Acuity Level of 4 divided by the total number of ED discharges	N/A	No	Yes	APC
% of ED patients with Acuity Level 3	Number of ED patients with an Acuity Level of 3 divided by the total number of ED discharges	N/A	No	Yes	APC
% of ED patients with Acuity Level 2	Number of ED patients with an Acuity Level of 2 divided by the total number of ED discharges	N/A	No	Yes	APC
% of ED patients with Acuity Level 1	Number of ED patients with an Acuity Level of 1 divided by the total number of ED discharges	N/A	No	Yes	APC
Charges measures
Charges - Total	Sum of all charges divided by volume of cases	Low	No	Yes	APC
Charges - Ambulance	Sum of ambulance charges divided by volume of cases Revenue codes: 0540-0549	Low	No	Yes	APC
Charges - Anesthesiology	Sum of anesthesiology charges divided by volume of cases Revenue codes: 0370-0372, 0374, 0379	Low	No	Yes	APC
Charges - Blood Administration	Sum of blood administration charges divided by volume of cases Revenue codes: 0390, 0391, 0399	Low	No	Yes	APC
Charges - Blood Use	Sum of blood use charges divided by volume of cases Revenue codes: 0380-0387, 0389	Low	No	Yes	APC
Charges - Cardiology	Sum of cardiology charges divided by volume of cases Revenue codes: 0480-0483, 0489, 0730-0732, 0739	Low	No	Yes	APC
Charges - Clinic Visit	Sum of clinic visit charges divided by volume of cases Revenue codes: 0510-0517, 0519	Low	No	Yes	APC
Charges - Durable Medical Equipment	Sum of durable medical equipment charges divided by volume of cases Revenue codes: 0290-0292, 0294, 0299	Low	No	Yes	APC
Charges - Emergency Department	Sum of emergency room department charges divided by volume of cases Revenue codes: 0450-0452, 0456, 0459	Low	No	Yes	APC
Charges - ESRD Revenue Setting	Sum of ESRD revenue-setting charges divided by volume of cases Revenue codes: 0800-0804, 0809, 0820-0825, 0829-0835, 0839-0845, 0849-0855, 0859-0882, 0889	Low	No	Yes	APC
Charges - Labor and Delivery	Sum of labor and delivery charges divided by volume of cases Revenue codes: 0720-0724, 0729	Low	No	Yes	APC
Charges - Laboratory and Pathology	Sum of laboratory& pathology charges divided by volume of cases Revenue codes: 0300-0307, 0309-0312, 0314, 0319, 0740, 0749, 0750, 0759	Low	No	Yes	APC
Charges - Lithotripsy	Sum of lithotripsy charges divided by volume of cases Revenue codes: 0790, 0799	Low	No	Yes	APC
Charges - Medical/Surgical Supplies	Sum of medical/surgical supply charges divided by volume of cases Revenue codes: 0270-0279, 0620-0624	Low	No	Yes	APC
Charges - MRI	Sum of MRI charges divided by volume of cases Revenue codes: 0610-0612, 0614-0616, 0618, 0619	Low	No	Yes	APC
Charges - Nuclear Medicine	Sum of nuclear medicine charges divided by volume of cases Revenue codes: 340-342, 349	Low	No	Yes	APC
Charges - Nursery and NICU	Sum of nursery and NICU Charges divided by volume of cases Revenue codes: 0230-0232, 0234, 0235, 0239, 0240, 0249	Low	No	Yes	APC
Charges - Occupation Therapy	Sum of occupational therapy charges divided by volume of cases Revenue codes: 0430-0434, 0439	Low	No	Yes	APC
Charges - Oncology	Sum of oncology charges divided by volume of cases Revenue codes: 0280, 0289, 0331-0333, 0335	Low	No	Yes	APC
Charges - Operating Room and Labor & Delivery	Sum of operating room labor and delivery charges divided by volume of cases Revenue codes: 0360-0362, 0367, 0369, 0710, 0719, 0720-0724, 0729	Low	No	Yes	APC
Charges - Organ Acquisition	Sum of organ acquisition charges divided by volume of cases Revenue codes: 0810-0814, 0819, 0890-0893, 0899	Low	No	Yes	APC
Charges - Other	Sum of other charges divided by volume of cases Revenue codes: 0220-0224, 0229-0235, 0239, 0240, 0249, 0520-0523, 0526, 0529, 0530, 0531, 0539, 0550-0553, 0559-0562, 0569-0572, 0579-0583, 0589, 0590, 0599-0604, 0640-0652, 0655-0663, 0669-0672, 0679, 0681-0684, 0689, 0700, 0709, 0760-0762, 0769-0771, 0779, 0780, 0900, 0901-0907, 0909-0925, 0929, 0931, 0932, 0940-0947, 0949-0952, 0990-0999	Low	No	Yes	APC
Charges - Other Not Including Nursery and NICU and Psych	Sum of other charges (without NICU or psych) divided by volume of cases Revenue codes: 0220-0224, 0229, 0520-0523, 0526, 0529-0531, 0539, 0550-0553, 0559-0562, 0569-0572, 0579-0583, 0589, 0590, 0599-0604, 0640-0652, 0655-0663, 0669-0672, 0679, 0681-0684, 0689, 0700, 0709, 0760-0762, 0769-0771, 0779, 0780, 0920-0925, 0929, 0931, 0932, 0940-0947, 0949-0952, 0990-0999	Low	No	Yes	APC
Charges - Outpatient Services	Sum of outpatient services charges divided by volume of cases Revenue codes: 0490, 0499, 0500, 0509	Low	No	Yes	APC
Charges - Pathology	Sum of pathology charges divided by volume of cases Revenue codes: 0310-0312, 0314, 0319	Low	No	Yes	APC
Charges - Pharmacy	Sum of pharmacy charges divided by volume of cases Revenue codes: 0250-0263, 0264, 0269, 0630-0637	Low	No	Yes	APC
Charges - Physical Therapy	Sum of physical therapy charges divided by volume of cases Revenue codes: 0420-0424, 0429	Low	No	Yes	APC
Charges - Professional Fee	Sum of professional fees charges Revenue codes: 0960-0964, 0969, 0971-0979, 0981-0989	Low	No	Yes	APC
Charges - Psych Services	Sum of psych charges divided by volume of cases Revenue codes: 0900-0907, 0909-0919	Low	No	Yes	APC
Charges - Radiology and CT Scan	Sum of radiology and CT scan charges divided by volume of cases Revenue codes: 0320-0324, 0329, 0350-0352, 0359, 0400-0404, 0409	Low	No	Yes	APC
Charges - Radiology, CT, Oncology & Nuclear Med.	Sum of radiology charges divided by volume of cases Revenue codes: 0280, 0289, 0320-0324, 0329-0333, 0335, 0339-0342, 0349-0352, 0359, 0400-0404, 0409	Low	No	Yes	APC
Charges - Respiratory Services	Sum of respiratory services charges divided by volume of cases Revenue codes: 0410, 0412, 0413, 0419	Low	No	Yes	APC
Charges - Respiratory Therapy	Sum of inhalation therapy charges divided by volume of cases Revenue codes: 0410, 0412, 0413, 0419	Low	No	Yes	APC
Charges - Speech Pathology	Sum of speech pathology charges divided by volume of cases Revenue codes: 0440-0444, 0449, 0470-0472, 0479	Low	No	Yes	APC
Charges - Therapy: Physical, Occupational, Speech	Sum of physical, occupational and speech therapy divided by volume of cases -Physical therapy revenue codes: 0420-0424, 0429 -Occupational therapy revenue codes: 0430-0434, 0439 -Speech pathology revenue codes: 0440-0444, 0449, 0470-0472, 0479	Low	No	Yes	APC
Charges - Used Durable Medical Equipment	Sum of used durable medical equipment charges divided by volume of cases Revenue code: 0293	Low	No	Yes	APC
Cost measures
Cost - Total	Sum of all costs divided by volume of cases	Low	No	Yes	APC
Cost - Ambulance	Sum of ambulance costs divided by volume of cases Revenue codes: 0540-0549	Low	No	Yes	APC
Cost - Anesthesiology	Sum of anesthesiology costs divided by volume of cases Revenue codes: 0370-0372, 0374, 0379	Low	No	Yes	APC
Cost - Blood Administration	Sum of blood administration costs divided by volume of cases Revenue codes: 0390, 0391, 0399	Low	No	Yes	APC
Cost - Blood Use	Sum of blood use costs divided by volume of cases Revenue codes: 0380-0387, 0389	Low	No	Yes	APC
Cost - Cardiology	Sum of cardiology costs divided by volume of cases Revenue codes: 0480-0483, 0489, 0730-0732, 0739	Low	No	Yes	APC
Cost - Clinic Visit	Sum of clinic visit costs divided by volume of cases Revenue codes: 0510-0517, 0519	Low	No	Yes	APC
Cost - Durable Medical Equipment	Sum of durable medical equipment costs divided by volume of cases Revenue codes: 0290-0292, 0294, 0299	Low	No	Yes	APC
Cost - Emergency Department	Sum of emergency room department costs divided by volume of cases Revenue codes: 0450-0452, 0456, 0459	Low	No	Yes	APC
Cost - ESRD Revenue Setting	Sum of ESRD revenue-setting costs divided by volume of cases Revenue codes: 0800-0804, 0809, 0820-0825, 0829-0835, 0839-0845, 0849-0855, 0859-0882, 0889	Low	No	Yes	APC
Cost - Intermediate ICU/CCU	Sum of intermediate ICU/ CCU costs (Revenue codes 206 and 214) divided by volume of cases Revenue codes: 206, 214	Low	No	Yes	APC
Cost - Labor and Delivery	Sum of labor and delivery costs divided by volume of cases Revenue codes: 0720-0724, 0729	Low	No	Yes	APC
Cost - Laboratory and Pathology	Sum of laboratory& pathology costs divided by volume of cases Revenue codes: 0300-0307, 0309-0312, 0314, 0319, 0740, 0749, 0750, 0759	Low	No	Yes	APC
Cost - Lithotripsy	Sum of lithotripsy costs divided by volume of cases Revenue codes: 0790, 0799	Low	No	Yes	APC
Cost - Medical/Surgical Supplies	Sum of medical/surgical supplies divided by volume of cases Revenue codes: 0270-0279, 0620-0624	Low	No	Yes	APC
Cost - MRI	Sum of MRI costs divided by volume of cases Revenue codes: 0610-0612, 0614-0616, 0618, 0619	Low	No	Yes	APC
Cost - Nuclear Medicine	Sum of nuclear medicine costs divided by volume of cases Revenue codes: 340-342, and 349	Low	No	Yes	APC
Cost - Nursery and NICU	Sum of nursery and NICU costs divided by volume of cases Revenue codes: 0230-0232, 0234, 0235, 0239, 0240, 0249	Low	No	Yes	APC
Cost - Occupation Therapy	Sum of occupational therapy costs divided by volume of cases Revenue codes: 0430-0434, 0439	Low	No	Yes	APC
Cost - Oncology	Sum of oncology costs divided by volume of cases Revenue codes: 0280, 0289, 0331-0333, 0335	Low	No	Yes	APC
Cost - Operating Room and Labor & Delivery	Sum of operating room labor and delivery costs divided by volume of cases Revenue codes: 0360- 0362, 0367, 0369, 0710, 0719, 0720-0724, 0729	Low	No	Yes	APC
Cost - Organ Acquisition	Sum of organ acquisition costs divided by volume of cases Revenue codes: 0810-0814, 0819, 0890-0893, 0899	Low	No	Yes	APC
Cost - Other	Sum of other costs divided by volume of cases Revenue codes: 0220-0224, 0229-0235, 0239, 0240, 0249, 0520-0523, 0526, 0529-0531, 0539, 0550-0553, 0559-0562, 0569-0572, 0579-0583, 0589, 0590, 0599-0604, 0640-0652, 0655-0663, 0669-0672, 0679, 0681-0684, 0689, 0700, 0709, 0760-0762, 0769-0771, 0779, 0780, 0900-0907, 0909, 0910-0925, 0929, 0931, 0932, 0940-0947, 0949-0952, 0990-0999	Low	No	Yes	APC
Cost - Other Not Including Nursery and NICU and Psych	Sum of other costs (without NICU or psych) divided by volume of cases Revenue codes: 0220-0224, 0229, 0520-0523, 0526, 0529-0531, 0539, 0550-0553, 0559-0562, 0569-0572, 0579-0583, 0589, 0590, 0599-0604, 0640-0652, 0655-0663, 0669-0672, 0679, 0681-0684, 0689, 0700, 0709, 0760-0762, 0769-0771, 0779, 0780, 0920-0925, 0929, 0931, 0932, 0940-0947, 0949-0952, 0990-0999	Low	No	Yes	APC
Cost - Outpatient Services	Sum of outpatient services costs divided by volume of cases Revenue codes: 0490, 0499, 0500, 0509.	Low	No	Yes	APC
Cost - Pathology	Sum of pathology costs divided by volume of cases Revenue codes: 0310-0312, 0314, 0319.	Low	No	Yes	APC
Cost - Pharmacy	Sum of pharmacy costs divided by volume of cases Revenue codes: 0250-0264, 0269, 0630-0637.	Low	No	Yes	APC
Cost - Physical Therapy	Sum of physical therapy costs divided by volume of cases Revenue codes: 0420-0424, 0429.	Low	No	Yes	APC
Cost - Professional Fee	Sum of professional fees costs Revenue codes: 0960-0964, 0969, 0971-0979, 0981-0989	Low	No	Yes	APC
Cost - Psych Services	Sum of psych costs divided by volume of cases Revenue codes: 0900-0907, 0909-0919	Low	No	Yes	APC
Cost - Radiology and CT Scan	Sum of radiology and CT scan costs divided by volume of cases Revenue codes: 0320-0324, 0329, 0350-0352, 0359, 0400-0404, 0409	Low	No	Yes	APC
Cost - Radiology, CT, Oncology & Nuclear Med.	Sum of radiology costs divided by volume of cases Revenue codes: 0280, 0289, 0320-0324, 0329-0333, 0335, 0339-0342, 0349-0352, 0359, 0400-0404, 0409	Low	No	Yes	APC
Cost - Respiratory Services	Sum of respiratory services costs divided by volume of cases Revenue codes: 0410, 0412, 0413, 0419	Low	No	Yes	APC
Cost - Respiratory Therapy	Sum of inhalation therapy costs divided by volume of cases Revenue codes: 0410, 0412, 0413, 0419	Low	No	Yes	APC
Cost - Speech Pathology	Sum of speech pathology costs divided by volume of cases Revenue codes: 0440-0444, 0449, 0470-0472, 0479	Low	No	Yes	APC
Cost - Therapy: Physical, Occupational, Speech	Sum of physical, occupational, and speech therapy divided by volume of cases -Physical therapy revenue codes: 0420-0424, 0429 -Occupational therapy revenue codes: 0430-0434, 0439 -Speech pathology revenue codes: 0440-0444, 0449, 0470-0472, 0479	Low	No	Yes	APC
Cost - Used Durable Medical Equipment	Sum of used durable medical equipment costs divided by volume of cases Revenue code: 0293	Low	No	Yes	APC
Total Indirect Costs	Total indirect costs as defined in client’s cost accounting system.	Low	No	Yes	APC
Total Direct Costs	Total direct costs as defined in client’s cost accounting system.	Low	No	Yes	APC
Total Variable Costs	Total variable costs as defined in client’s cost accounting system.	Low	No	No	N/A
Total Fixed Costs	Total fixed costs as defined in client’s cost accounting system.	Low	No	No	N/A
Other Utilization measures
LOS (hours)	Average length of stay, in hours, for all patients	Low	No	Yes	APC
Contractual Allowance and Adjustments	Contractual allowance and adjustments equals charges minus total actual payment	Low	No	No	N/A
Number of Consultants	Number of consultant physicians utilized for this encounter	Low	No	Yes	APC
Expected Payment	Total expected payment as defined in client’s cost accounting system.	Low	No	No	N/A
Total Actual Payment	Total actual payment as defined in client’s cost accounting system.	Low	No	No	N/A
Expected Net Income	Expected total actual payment minus total costs	High	No	No	N/A
Net Income	Net Income equals total actual payment minus total costs	High	No	No	N/A
Expected Contribution Margin	Expected Total Actual Payment minus Total Variable Costs	High	No	No	N/A
Contribution Margin	Total Actual Payment minus Total Variable Costs	High	No	No	N/A
Medicare Contribution Margin	Total Actual Medicare Payment minus Total Variable Costs	High	No	No	N/A
Medicare Net Income	Total actual Medicare payment minus total costs	High	No	No	N/A
Medicare Reimbursement	Total actual Medicare payment	High	No	No	N/A

ED Payments & Adjustments measures

These measures are based on the Transaction Type specified in your billing data.

Measure name	Description	Polarity	All Payer benchmarks?	Medicare benchmarks?	Benchmark detail level
Final Billed	A flag indicating if the account has been Final Billed	High	No	No	N/A
Patient Payment at POS	Amount of patient payment made on the date(s) of service	High	No	No	N/A
Patient Pay Write-Off	Sum of all charge amounts written off by the provider because the patient did not pay them	Low	No	No	N/A
Charity Care	Sum of all charges discounted by the facility as free or reduced-cost care for patient in financial hardship	Low	No	No	N/A
Other Adjustments	Sum of all other adjustments made to the Open Balance	Low	No	No	N/A
Payments - Patient	Sum of all payments made to an account by the patient (classified "Self")	Low	No	No	N/A
Payments - Insurance	Sum of all payments made to an account by an insurance provider; this includes Blue Cross/Blue Shield, Champus/Tricare/VA, CHP, Medicaid, Medicare, Other Govt, Private Ins, Workers Compensation and possibly others.	Low	No	No	N/A
Payments - Total	Sum of all Patient and Insurance payments made to an account	Low	No	No	N/A
Contractual Allowance	Sum of all Contractual Allowance adjustments made to an account; contractual allowance refers to the amount an insurance company does not pay to an account because of previous agreements with the facility as to the charges for a service.	Low	No	No	N/A
Denials	Sum of all charge amounts denied by insurance	Low	No	No	N/A
Payments - Other	Sum of all payments made to a patient account not classified as "Insurance" or "Patient Pay"; this can include Charity, Other, Unknown, and missing values.	Low	No	No	N/A
Employee Discount	Sum of all Employee Discount adjustments made to an account	Low	No	No	N/A
Self-Pay Discount	Sum of all Self-Pay Discount adjustments made to an account	Low	No	No	N/A
Not Covered by Insurance	Sum of all charges on an account not paid by insurance because they are not covered	Low	No	No	N/A

ED Revenue Cycle measures

These measures are based on billing data sent to Clinical Analytics.

Measure name	Description	Polarity	All Payer benchmarks?	Medicare benchmarks?	Benchmark detail level
Aging Category (366+)	Account was paid in full (Open Balance = $0) over 365 days of the patient discharge date	N/A	No	No	N/A
Aging Category (181-365)	Account was paid in full (Open Balance = $0) within 181-365 days of the patient discharge date	N/A	No	No	N/A
Aging Category (151-180)	Account was paid in full (Open Balance = $0) within 151-180 days of the patient discharge date	N/A	No	No	N/A
Aging Category (121-150)	Account was paid in full (Open Balance = $0) within 121-150 days of the patient discharge date	N/A	No	No	N/A
Aging Category (91-120)	Account was paid in full (Open Balance = $0) within 91-120 days of the patient discharge date	N/A	No	No	N/A
Aging Category (61-90)	Account was paid in full (Open Balance = $0) within 61-90 days of the patient discharge date	N/A	No	No	N/A
Aging Category (31-60)	Account was paid in full (Open Balance = $0) within 31-60 days of the patient discharge date	N/A	No	No	N/A
Aging Category (0-30)	Account was paid in full (Open Balance = $0) within 30 days of the patient discharge date	N/A	No	No	N/A
Aging Category - Closed to Zero Balance	A letter designating the aging category of the account based on the Zero Balance Age. Category assignments are as follows: A represents 0-30 days; B represents 31-60 days; C represents 61-90 days; D represents 91-120 days; E represents 121-150 days; F represents 151-180 days; G represents 181-365 days; and H represents 366+ days	N/A	No	No	N/A
Zero Balance Age (in Days)	Number of days from the patient discharge date to the date when Open Balance is equal to $0	Low	No	No	N/A
Open Balance	Total open balance on the account	Low	No	No	N/A
Credit Balance	Amount of overpayment on the account; this amount shows $0 if the Open Balance is greater than or equal to $0	Low	No	No	N/A