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CMS165v11 Clarification of collecting BP values obtained at another facility

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      ​Thank you for your inquiry regarding CMS165v11 Controlling High Blood Pressure (2023 Performance Period).

      1. In addition to BP readings (numerator criteria), the measure specification requires documentation such as hypertension diagnosis and a qualifying encounter for meeting the denominator criteria. There is no provider-type requirement that is outlined by the specification. If the provider has approved the information for entry into the EHR or is basing care off the information, it can be used. You may refer to the measure specification for specific value sets/codes required of each data criteria. If you have questions relating to program requirements, you may submit questions to the QPP helpdesk.
      2. Per measure specification's CQL logic, the BP readings are not tied to a specific encounter, thus BP readings do not need to be during a visit. However, the BP readings should be dated, as the measure assesses the most recent BP reading completed during measurement period.
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      ​Thank you for your inquiry regarding CMS165v11 Controlling High Blood Pressure (2023 Performance Period). 1. In addition to BP readings (numerator criteria), the measure specification requires documentation such as hypertension diagnosis and a qualifying encounter for meeting the denominator criteria. There is no provider-type requirement that is outlined by the specification. If the provider has approved the information for entry into the EHR or is basing care off the information, it can be used. You may refer to the measure specification for specific value sets/codes required of each data criteria. If you have questions relating to program requirements, you may submit questions to the QPP helpdesk. 2. Per measure specification's CQL logic, the BP readings are not tied to a specific encounter, thus BP readings do not need to be during a visit. However, the BP readings should be dated, as the measure assesses the most recent BP reading completed during measurement period.
    • CMS0165v11

      Good morning, I am looking for clarification for qualifying diastolic and systolic blood pressure readings for CMS 165v11. 1.  For the BP completed by the clinician, can documentation from an outside facility be entered into the EHR and mapped for this measure? We have specialists that are not treating the patient's HTN, but recording BP during visits. They then refer back to their Primary Care provider for HTN management. 2. Could the specialist request and document the BP reading from the patient's PCP, which may have occurred on a different date of service from the office visit? Would these values be able to be mapped to the measure? These BP readings would not necessarily match the date of encounter and would need to be entered separately from the OV note. Any clarification would be greatly appreciated. 

            edave Mathematica EC eCQM Team
            ktucker Katherine Tucker
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