Thank you for your question. The standards and tool versions listed for each reporting/performance period are the versions used to create and support the implementation of the specific reporting/performance period specifications. QDM v5.3 is used to support the measure specifications for the 2019 reporting/performance period, and QDM 5.4 is used to support measure specifications for the 2020 reporting/performance period. For the 2019 reporting/performance period, QDM 5.3 does not allow for substitution of Relevant Period for Author date Time unless specified as such within the measure. QDM 5.3 defines Author dateTime as ‘the time the data element was entered into the clinical software’, and does not offer any additional timing designation for the datatype Intervention, Performed.

For CMS50v7 and CMS2v8, Author datetime is used for Intervention Performed. In QDM v5.3 §4.0.14 (page 27), the definition of Intervention Performed references the Relevant Period (start time – the time the intervention begins; stopTime – the time the intervention ends) and the attributes include both Relevant Period and Author datetime. Can we use Relevant Period (i.e., the actual date the intervention performed) verses Author datetime (i.e., the time it was documented in the EHR). Please see examples below? 1. CMS2v8 : Additional Evaluation for Depression as Follow Up for Adolescent ["Intervention, Performed": "Additional evaluation for depression - adolescent"] AdditionalEvalAdolescent with "Most Recent Adolescent Depression Screening Positive" AdolescentScreening such that AdditionalEvalAdolescent.authorDatetime same day as AdolescentScreening.authorDatetime Can we use the date of the intervention (i.e., “Additional evaluation for depression - adolescent“) was performed instead of the date it was documented in the EHR? These dates may differ if the provider does not document chart the same day of the intervention. 2. CMS50v7 First Referral During Measurement Period First(["Intervention, Performed": "Referral"] Referral where Referral.relevantPeriod starts during "Measurement Period" sort by authorDatetime For CMS50, the “Referral” uses Relevant Period. For consistency, can we sort by Relevant Period instead of Author datetime? The Relevant Period and Author datetime may differ.