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  1. eCQM Issue Tracker
  2. CQM-6128

CMS 155 Weight Assessment inappropriate patients brought into the initial population due to measure logic inaccuracies.

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      ​Thank you for your question regarding the Initial Population/Denominator criteria for CMS155v12: Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents. The intent of this measure is to look for encounters performed by primary care providers (PCPs) or obstetrician/gynecologists (OB/GYNs) in the Initial Population. As of now, providers can decide which measures they want to report and need to apply the necessary restrictions at the individual provider level.

      As stated in the measure logic, visits that meet the requirements for the Initial Population are those associated with any codes listed in the value sets specified in the "Qualifying Encounters" definition. PCPs and OB/GYNs who bill the corresponding visit codes are considered eligible for the measure. The term 'PCP' encompasses primary care physicians, pediatricians, nurse practitioners, and other healthcare professionals who provide primary care services. On the other hand, 'OB/GYN' refers exclusively to obstetricians and gynecologists.

      We are currently exploring the possibility of incorporating specialty criteria into the measure logic in a future revision.
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      ​Thank you for your question regarding the Initial Population/Denominator criteria for CMS155v12: Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents. The intent of this measure is to look for encounters performed by primary care providers (PCPs) or obstetrician/gynecologists (OB/GYNs) in the Initial Population. As of now, providers can decide which measures they want to report and need to apply the necessary restrictions at the individual provider level. As stated in the measure logic, visits that meet the requirements for the Initial Population are those associated with any codes listed in the value sets specified in the "Qualifying Encounters" definition. PCPs and OB/GYNs who bill the corresponding visit codes are considered eligible for the measure. The term 'PCP' encompasses primary care physicians, pediatricians, nurse practitioners, and other healthcare professionals who provide primary care services. On the other hand, 'OB/GYN' refers exclusively to obstetricians and gynecologists. We are currently exploring the possibility of incorporating specialty criteria into the measure logic in a future revision.
    • CMS0155v12
    • CMS0155v11
    • Non-PCP and non-OB/GYN providers are being considered as qualifying encounters and putting patients into the initial population which is different than what the guidance of this measure discusses.

      CMS155 Weight Assessment measure has an initial population as described:

      Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period

      However, the measure logic does not require visits to be by a PCP or OB/GYN only. I've searched the issue tracker and have seen recognition of this, but not a proposed solution. Is there a solution being considered?

            edave Mathematica EC eCQM Team
            jklesmith Jill
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