Should Numerator Intervention performed by 1 provider count for other providers at the practice?

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    • Type: Implementation Problem
    • Resolution: Answered
    • Priority: Minor
    • Component/s: Guidance
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    • Nicholas
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      When a patient is drawn into the denominator for an individual provider, and the system contains the information that satisfies the measure, the numerator is satisfied for that patient. This is true unless the measure specification directly requires the numerator criteria to be satisfied by the specific provider who is generating the report. This is because we do not want to incentivize unnecessary care caused by a desire for measure performance. Thus, for this measure, the answer to your question is yes, if the patient falls into the measure for a provider and the numerator is satisfied, the patient passes the measure. If the patient did not have a qualifying encounter with the reporting provider, they will not be counted in the denominator and therefore would not be reported.
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      When a patient is drawn into the denominator for an individual provider, and the system contains the information that satisfies the measure, the numerator is satisfied for that patient. This is true unless the measure specification directly requires the numerator criteria to be satisfied by the specific provider who is generating the report. This is because we do not want to incentivize unnecessary care caused by a desire for measure performance. Thus, for this measure, the answer to your question is yes, if the patient falls into the measure for a provider and the numerator is satisfied, the patient passes the measure. If the patient did not have a qualifying encounter with the reporting provider, they will not be counted in the denominator and therefore would not be reported.

      At a practice with multiple providers where a patient counts in the denominator of CMS69 for all the providers, will the Intervention documented by one provider that meets the numerator also make the other providers compliant for CMS69 numerator as well?

            Assignee:
            Julia Skapik (Inactive)
            Reporter:
            Nicholas D (Inactive)
            Nicholas D (Inactive)
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