Thank you for your inquiry about CMS138v12, Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention (2024 performance period). The measure identifies 3 populations. Numerator 1 looks for screening completed. Numerator 2 and Numerator 3 look for tobacco cessation interventions if the screening is positive. One way of meeting tobacco cessation intervention is through documentation of an "Intervention, Performed" using any codes from the value set "Tobacco Use Cessation Counseling" (2.16.840.1.113883.3.526.3.509). You can reference the codes containing these value sets on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/ . Click on the “Search Value Sets” tab and enter the value set ID to review codes included in the respective value set. Concepts such as written self-help materials (e.g., brochures, pamphlets) and complementary/alternative are not included in the value set and do not qualify for the numerator on their own. Education pamphlets may qualify if they are included in addition to the tobacco counseling; the intent is that education be provided via two-way interaction between the patient and provider. For example, SNOMED 22532300 Smoking cessation education is included in the "Tobacco Use Cessation Counseling" value set as it represents the concept. Providing the patient written materials without one of the intervention types found within the TobaccoUseCessationCounseling value set does not fulfill the numerator criteria for either 'Population 2' or 'Population 3', for this measure.