CMS 157 is an episode of care measure, as is stated within the guidance field. While ‘Radiation Treatment Management’ is an actual procedure, it serves as its own type of encounter because an office visit or face-to-face interaction is not required in combination with this data element to meet the initial patient population. The language used within the guidance field - radiation treatment management encounter – is a bit misleading as this is truly a procedure. What we meant by the term ‘encounter’ within the guidance is actually that a patient/physician interaction occurred that met the constraints outlined in the IP. Because chemotherapy can be administered when a physician is not present (eg, by an oncology nurse), an office/face-to-face visit with a physician is required in conjunction with the course of chemotherapy. Radiation treatment is always performed in the presence of/by a physician, so no additional encounter is required.   In version 4 of this measure which was published in May 2015, we have included the item count field which further identifies the unit of measure for the eCQM. For CMS 157, this would be looking at every instance of an office visit or face-to-face interaction encounter, and every radiation treatment management procedure.