Hello, Thank you for your inquiry about CMS2v10: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. The measure specification allows for any normalized and validated depression screening tool developed for the patient population in which it is being utilized. Therefore, the measure does not list all of the possible tools or the definition of a positive screen for all possible tools. The PHQ-9 is an appropriate standardized depression screening tool that meets numerator criteria. Information on how to use the PHQ-9 screening tool can be found at the following link: https://www.phqscreeners.com/images/sites/g/files/g10016261/f/201412/instructions.pdf . We encourage providers to use this resource for instructions on how to interpret PHQ-9 scores and to use their clinical judgement, keeping in mind that this measure looks at the most recent completed depression screening to determine the patient's status and if appropriate follow-up was documented.

Good afternoon, Our project team received the inquiry below from an external partner regarding the following eCQM measure: Preventive Care and Screening: Screening for Depression and Follow-Up Plan (CMS 2v10). Our team drafted a proposed response, which is included below. To ensure that we have the correct understanding of the measure, we would appreciate any insight your team is able to provide on this inquiry. Inquiry: For the PHQ-9, what score should we consider as positive for the Preventive Care and Screening: Screening for Depression and Follow-Up Plan? 10 and above, or 5 and above? Draft Response: Thank you for your inquiry. Pfizer Inc., the PHQ-9 tool developer, describes the below proposed treatment actions in their assessment instruction manual: https://www.phqscreeners.com/images/sites/g/files/g10016261/f/201412/instructions.pdf Proposed Treatment Action by PHQ-9 Score: 0 - 4: None-minimal depression Proposed treatment action: None 5 - 9: Mild depression Proposed treatment action: Watchful waiting; repeat PHQ-9 at follow-up 10 - 14: Moderate depression Proposed treatment action: Treatment plan, considering counseling, follow-up and/or pharmacotherapy 15 - 19: Moderately Severe depression Proposed treatment action: Active treatment with pharmacotherapy and/or psychotherapy 20 - 27: Severe depression Proposed treatment action: Immediate initiation of pharmacotherapy and, if severe impairment or poor response to therapy, expedited referral to a mental health specialist for psychotherapy and/or collaborative management A score of 5 - 9 is considered mild depression. According to these guidelines from Pfizer, the proposed treatment action includes watchful waiting and to repeat the PHQ-9 at the next visit. The patient would need a follow-up plan documented for a PHQ-9 score of 5 or above because treatment actions are warranted and should be documented. Thank you! Megan