6/24/2020: Update to Original Response: Clarification of the original solution which states "The exclusion of modifiers within the electronic clinical quality measure (eCQM) specifications has not changed, as the CPT modifiers are not recommended for use according to the standards and are not included as a requirement for eCQM reporting." CPT codes are used in eCQMs but CPT code modifiers are not used in eCQMs because eCQM specifications do not have the capability of including code modifiers. If a CPT code with a modifier is submitted for an eCQM, the CPT code is utilized, but the CPT code modifier is excluded or not used by the measure. This applies to any codes listed in value sets for eCQMs. Codes included in the value sets can be used by the respective measure even if the code is submitted with a modifier. The modifier code, however, is not directly used in the measure logic. While the eCQM logic will not use the modifier, a code with a modifier should only be submitted if the modifier represents an encounter or action that is appropriate for the measure and not otherwise prohibited in the measure specification, such as the measure's guidance statement.   2/28/2020: Original Response The exclusion of modifiers within the electronic clinical quality measure (eCQM) specifications has not changed, as the CPT modifiers are not recommended for use according to the standards and are not included as a requirement for eCQM reporting. Measure specifications can vary by data source and intended implementation. The modifiers – both those mentioned in the ticket as well as others – continue to be valid, where noted, within the QPP specifications for claims and CQM (registry) reporting. In order to determine whether any modifiers are required for a measure, we recommend reviewing the intended implementation year's specifications as the criteria or requirements can change from year to year.

We are looking for guidance on the recent stance of the inclusion or exclusion of modifiers with the 2019 eCQM specifications. In reference to a previous historical ticket, CQM-2234 states "Currently, the recommended national standard tools used in electronic clinical quality measure specifications do not have the capability to include code modifiers (i.e., CPT modifiers), and code modifiers are not required for reporting on electronic clinical quality measures in the Meaningful Use program." However, the MIPS CQM specifications due provide guidance on a measure by measure basis on the inclusion/exclusion of modifiers in some measures such as 155, 69, 117, 131, 68, 127, 147, 137, 50, 177 and 66 with the following modifiers: GQ, GT, 95, 02, 1P, 2P, 3P, 8P. Can you please provide guidance on the expectation of the implementation of eCQMs in regard to modifiers? Is the CQM-2234 issue still current for this guidance?