Hey Rich: No changes from CDMv5 to CDMv5 in the cost fields in the _COST tables. Only ancillary changes are: 1) support for CURRENCY_CONCEPT_ID, 2) expansion to allow costs specific to visits in VISIT_COST and to devices in DEVICE_COST, and 3) DRGs moved to OBSERVATION records from PROCEDURE_COST field.
I haven’t seen much activity within the community using these tables for analytical use cases, but the original intention was to enable capture of costs (not charges) from both payer and patient perspective. The primary fields were loosely modeled off what others have recieved in claims data (common convention I’ve seen in ETLs: costs associated with medical claims go into PROCEDURE_COST while costs for pharmacy claims go in DRUG_COST). The key insight I’ve gained from these tables is that it is critical to understand which perspective(s) the source data provides when thinking about cost, as many databases have incomplete capture of the total expenditure.
Cheers,Patrick