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  2. CQM-6304

CMS2 - Followup criteria - Multiple providers

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    • Resolution: Answered
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      ​​Thank you for your inquiry on CMSv12/v13, Preventive Care and Screening: Screening for Depression and Follow-Up Plan. In order to meet the Numerator, a patient must be screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter. Per your examples, Providers B & C would meet the Numerator and Providers A & D would not meet the Numerator. The patients for all 4 providers would meet the Denominator.
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      ​​Thank you for your inquiry on CMSv12/v13, Preventive Care and Screening: Screening for Depression and Follow-Up Plan. In order to meet the Numerator, a patient must be screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter. Per your examples, Providers B & C would meet the Numerator and Providers A & D would not meet the Numerator. The patients for all 4 providers would meet the Denominator.
    • CMS0002v13
    • CMS0002v12

      For CMS2, numerator criteria states that 'Patients screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized tool AND if positive, a follow-up plan is documented on the date of or up to two days after the date of the qualifying encounter'.

       

      For the below scenario which all providers get numerator credit for 2023 Measurement Period in a shared EMR:

      Scenarion1:

      Provider A: Encounter on 1/1/2023 and Positive depression screening assessment on 1/1/2023.

      Provider B: Encounter on 1/14/2023.

      Provider C: Encounter on 1/15/2023 and does the followup.

      Provider D: Encounter on 3/20/2023. 

      In this scenario,

      Provider A has denominator qualifying encounter and screening assessment on same day(1/1/2023), but the followup(1/1/2023) is not within 2days from that encounter.

      Provider B has denominator qualifying encounter(1/14/2023) and screening assessment(1/1/2023) which is within 14days prior to that encounter, and followup(1/15/2023) within 2days from that encounter.

      Provider C has denominator qualifying encounter(1/15/2023)  and screening assessment(1/1/2023) which is within 14days prior to that encounter, and followup(1/15/2023) within 2days from that encounter.

      Provider D has only  denominator qualifying encounter(03/20/2023).

      Should only Provider B, Provider C get numerator credit, as they have valid encounter and screening and followup within valid timeframes from their respective encounters. Provider A, Provider D only get denominator credit as they do not have screening and/or followup in valid timeframes from their respective encounters.

       

            edave Mathematica EC eCQM Team
            priyankamurthy Priyanka Murthy
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