Thank you for your inquiry. In order to meet the intent of the measure, the depression screen and follow-up, if the screen is positive, must be documented on the same day as the qualifying encounter. We will, however, further review your request to consider the depression screen outside of the eligible encounter with our expert panel in preparation for the next annual update. Please let us know if you have any further questions.​

We are noticing in data validation activities that depression screenings performed in episode-based visits are not meeting numerator conditions. Prenatal care, cardiac rehab, or annual Medicare Wellness visits may be delivered in multiple visits, but only billed once. For instance, a patient has an initial prenatal visit done with a negative depression screening on 6/8/2018, but her prenatal visits are billed on 8/18/2018. She is failing the depression screening measure because her depression screening was not done on the date of the billed episode 8/18/2018. Another example is when a nurse sees a patient on 8/1/2018 to start the Medicare Wellness visit and performs a depression screening. Results are negative. The patient sees the provider several days later to finish out the visit. Because the depression screening was not done on the day of the visit, the patient does not meet numerator conditions. Our EHR vendor does not give us an option to map the prenatal visits, CV Rehab therapy visits, or nurse Medicare Wellness visits. We believe these situations meet the intent of the measure: to screen patients in a setting where accurate diagnosis, effective treatment, and appropriate follow up can occur. Please consider simplifying the numerator statement to allow the latest depression screening and review to occur any time during the measurement period and not tie it to a particular visit.