Thank you for your question regarding the Initial Population/Denominator criteria for CMS155v11, Weight Assessment and Counseling for Nutrition and Physical Activity for Children and 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. You are correct in that the denominator encounter logic/codes are not provider specific. 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' refers to who your organization allows to be PCPs, but can encompass 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. As part of the annual update process, we are exploring the possibility of incorporating specialty criteria into the measure logic in a future.

Per the metric description, this measure is not applicable to specialty providers outside of primary care or OBGYN. Yet the metric logic is pulling in specialty visits into the denominator thus increasing the denominator and negatively impacting quality scores.