Thank you for your question. The intent of this measure is for a suicide risk assessment to be performed during every encounter for a new or recurrent episode of Major Depressive Disorder (MDD). In version 5 of this eCQM, published in April 2016, the diagnosis of MDD must start during a particular encounter. Based on the information you provided, it does not appear that the encounter on December 2, 2016, would meet the initial population requirement, as the diagnosis of MDD did not start during that encounter. If, however, the MDD diagnosis had been documented in the patient’s EMR as starting during the December 2, 2016, encounter, the initial population criteria would be met for that encounter, and you would then assess whether or not the suicide risk assessment was performed during that encounter, thereby satisfying the numerator criteria. A suicide risk assessment must be performed at all encounters for a new diagnosis of MDD and all encounters for a recurrent diagnoses in order to meet numerator requirements for the measure. In version 6 of this eCQM, published in May 2017 for 2018 reporting, we added constraints to the encounter for MDD diagnosis in an attempt to more accurately capture recurrent episodes of MDD.