​​Thank you for your question on CMS506, Safe Use of Opioids - Concurrent Prescribing . The measure is intended to evaluate patient risk at discharge regardless of who prescribed which medication. If the patient is instructed to take medication listed in either the Schedule II & III Opioid Medications (2.16.840.1.113762.1.4.1111.165) value set or the Schedule IV Benzodiazepines (2.16.840.1.113762.1.4.1125.1) value set at discharge, whether the medication is newly prescribed or a continuation of a previously prescribed medication, the medication will count towards the numerator. This means that the patient in scenario one, taking both Oxycodone and Alprazolam at discharge, would be in the numerator. The patient in scenario two would be in the numerator if the patient is told to take Oxycodone and continue taking Alprazolam after discharge until they are able to speak to their primary care provider. If the patient is told to only take Oxycodone after discharge until they speak to to their primary care provider, the patient would be in the denominator but not the numerator. Please let us know if you have additional questions.