Thank you for your inquiry for CMS165v12 (2024 performance period). The blood pressure reading in the numerator does not need to be associated with the qualifying encounter in the denominator or any other qualifying encounter. As the measure guidance stated, "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." In short, the information would need to be documented in a structured field in the EHR, approved for entry by the provider. Your question regarding QPP reporting has been redirected to the QualityNet Service Desk, and the following ticket has been opened for you: CS2201926 You will be contacted by their team and assigned a customer service representative who will work to resolve your inquiry. In case of additional questions please reference the contact information for the CCSQ Support Center, that can be found at https://qualitynet.cms.gov/support