The rising cost of healthcare is a globally pressing concern. This makes detailed attention to the way inwhich costing is carried out of central importance. This article offers a framework for considering theinterdependencies between adominant elementof the contemporary healthcare context, i.e., Diagnosis Related Group (DRG) systems, and costing practices. DRG-based payment systems strongly influence costing practices in multipleways. Inparticular, settingDRGtariffs requires highly standardized costingpractices linked with specific skill sets from management accountants and brings other jurisdictions (e.g., clinical coding) to bear on costing practice. These factors contribute to the fragmentation of the jurisdiction of management accounting.