Thank you for your inquiry for CMS165v12 Controlling High Blood Pressure (2024 performance period). To clarify, per measure logic, the blood pressure readings in the numerator do not need to be associated with the qualifying encounter in the denominator or any other qualifying encounter. Please reference the measure specifications, which can be found on the eCQI Resource Center https://ecqi.healthit.gov/ . Specifically, the guidance section of the header indicates the following: In reference to the numerator element, only blood pressure readings performed by a clinician or an automated blood pressure monitor or device are acceptable for numerator compliance with this measure. This includes blood pressures taken in person by a clinician and blood pressures measured remotely by electronic monitoring devices capable of transmitting the blood pressure data to the clinician. Blood pressure readings taken by an automated blood pressure monitor or device and conveyed by the patient to the clinician are also acceptable. It is the clinician’s responsibility and discretion to confirm the automated blood pressure monitor or device used to obtain the blood pressure is considered acceptable and reliable and whether the blood pressure reading is considered accurate before documenting it in the patient’s medical record. Furthermore, blood pressure readings performed by the clinical staff, e.g., medical assistant, nurse, nurse practitioner, are qualifying documentation for evaluating numerator compliance.