According to the guidance on CPC+ quality reporting, organizations reporting on CPC+ need to report all patients (including all payers and the uninsured) who were seen one or more times at the practice site location during the calendar year (CY) measurement period by CPC+ clinicians (TIN/NPI) and who met the inclusion criteria for the initial patient population (IPP)/denominator. This is interpreted as one outcome for each patient with that outcome reported if the patient is seen in the practice.

However, the Meaningful Use/MIPS reporting logic for CMS 156 checks whether a patient had a medication prescribed by the provider being evaluated to determine whether the patient is included in the numerator for the measure. From the measure guidance: “The intent of the measure is to assess if the reporting provider ordered the high-risk medication(s). If the patient had a high-risk medication previously prescribed by another provider, they would not be counted towards the numerator unless the reporting provider also ordered a high-risk medication for them.”

Does this provider-specific check apply to CPC+ reporting as well? For example, if a patient is seen at a practice and a high-risk medication was ordered by a provider not in the practice, is the patient still counted in the numerator for CPC+?