Telehealth Guidance for eCQMs for 2020 Quality Reporting

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      ​For the 2020 reporting year, the 42 telehealth-eligible measures, as noted in the guidance located on the eCQI Resource Center (https://ecqi.healthit.gov/sites/default/files/2020-eCQM-Telehealth-Guidance-Document.pdf) are classified as eligible for telehealth encounters based on Medicare telehealth-eligible codes included in the measures' encounter value sets.

      For eCQMs not eligible for telehealth encounters, it is important to note that telehealth is not appropriate for encounters within these eCQMs based on other information provided directly in the measure specification, such as in the measure guidance section, precluding them from becoming telehealth eligible.

      In the scenario you provide, specific to CMS68 and CMS68, you are correct. As noted in the telehealth guidance, CMS68 represents an eCQM measure in which the quality action can be completed during a telehealth encounter, while CMS69 represents a measure where the quality action cannot be completed during a telehealth encounter. Therefore, while the initial patient-visit for each measure could be coded G0270, only CMS68 includes numerator quality action that may be completed via telehealth.
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      ​For the 2020 reporting year, the 42 telehealth-eligible measures, as noted in the guidance located on the eCQI Resource Center ( https://ecqi.healthit.gov/sites/default/files/2020-eCQM-Telehealth-Guidance-Document.pdf ) are classified as eligible for telehealth encounters based on Medicare telehealth-eligible codes included in the measures' encounter value sets. For eCQMs not eligible for telehealth encounters, it is important to note that telehealth is not appropriate for encounters within these eCQMs based on other information provided directly in the measure specification, such as in the measure guidance section, precluding them from becoming telehealth eligible. In the scenario you provide, specific to CMS68 and CMS68, you are correct. As noted in the telehealth guidance, CMS68 represents an eCQM measure in which the quality action can be completed during a telehealth encounter, while CMS69 represents a measure where the quality action cannot be completed during a telehealth encounter. Therefore, while the initial patient-visit for each measure could be coded G0270, only CMS68 includes numerator quality action that may be completed via telehealth.
    • EP

      We are seeking clarification on the  “Telehealth Guidance for Electronic Clinical Quality Measures (eCQMs) for Eligible Professional/Eligible Clinician 2020 Quality Reporting”

      Telehealth-eligible CPT and HCPCS codes may be included in value sets where the required quality action in the numerator cannot be completed via telehealth. Currently, the eCQM logic does not evaluate the use of modifiers in eCQM  and there is no identifier that will evaluate whether the qualify action was  performed in person visit vs a Telehealth visit. How should eligible providers and clinicians ensure that quality action is met for measures that are not eligible for telehealth?

      Please see examples below of common code shared among value sets below. In this scenario, if the patients visit is coded with G0270 code, is the expectation that CMS 68( a measure that is eligible for Telehealth) will be Met; assuming that all numerator actions were completed and CMS 69 (a measure that is not eligible for Telehealth) will be Not Met?

       

      Code Measures
      G0439 CMS 122, CMS 125, CMS 127, CMS 128, CMS 130, CMS 131, CMS 134, CMS 138, CMS 139, CMS 147, CMS 156, CMS 159, CMS 160, CMS 165, CMS 22, CMS2, CMS 347, CMS 68, CMS 69
      G0270 CMS 68, CMS 69
      G0108 CMS 68, CMS 69
      G0438 CMS 122, CMS 125, CMS 127, CMS 128, CMS 130, CMS 131, CMS 134, CMS 138, CMS 139, CMS 147, CMS 156, CMS 159, CMS 160, CMS 165, CMS 2, CMS 347, CMS 69, CMS 69

       

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Aniek Valentine (Inactive)
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            2 Vote for this issue
            Watchers:
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              Created:
              Updated:
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