Thank you for inquiry on CMS161 (NQF 0104e) Adult Major Depressive Disorder (MDD): Suicide Risk Assessment. The link that you provided is for CMS161v8 which is for performance year 2020. The most current version of the measure specification (i.e., CMS161v11 – performance year 2023) is published on the eCQI Resource Center ( https://ecqi.healthit.gov/ ) For question 1, Adult Major Depressive Disorder (MDD): Suicide Risk Assessment is an electronic clinical quality measure (eCQM). The measure uses data electronically extracted from discrete coded fields electronic health records (EHRs) and/or health information technology systems to measure the quality of healthcare provided. The measure is not designed to be used for claims/administrative reporting. For question 2, An example of a report that has published data about CMS161 is the MIPS Historical Quality Benchmarks report which CMS publishes annually and provides historical performance results and benchmarks for measures in the CMS MIPS program. These benchmark reports can be found on CMS Quality Payment Program website ( https://qpp.cms.gov/ ). For question 3, CMS161 does not capture which suicide risk assessment tool was used by the clinician. Because the measure does not capture this, we do not have information about which screening tool is used predominantly. The guidance section of the specification reflects that the use of any standardized tool or instrument to assess suicide risk will meet numerator performance and the definition section of the specification indicates that the specific type of suicide risk assessment is at the discretion of the individual clinician and should be specific to the needs of the patient. For question 4, It is not acceptable to combine results from different screening tools performed at different visits to indicate that a screening was performed. CMS161 is an episode-of-care measure which means that the patient’s suicide risk assessment must be completed at the visit during which a new diagnosis or recurrent major depressive disorder (MDD) episode was identified to count towards the numerator. We hope this helps.