Thank you for question on CMS2v12: Preventive Care and Screening: Screening for Depression and Follow-Up Plan. CMS2v12 is in the CMS MIPS program. We cannot comment on other payors or payor programs. For CMS2 in MIPS, the minimum requirement would be one depression screening on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening 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. There can be situations where a patient could have more than 1 screening during the measurement period.

After reviewing the PY6 specifications manual, we are writing to confirm our interpretation of the CMS-2 Depression Screening and Follow-Up measure. Our interpretation, and the general intent of the measure, is to ensure that patients are screened for depression on an annual basis to care for any mental health needs. While we recognize the need for a patient to have a MediCal encounter in a primary care setting during the performance year in order to meet the qualifications of the denominator population, to meet the metric intent, we believe that if we can evidence a patient has been screened for depression during the performance year, it would be sufficient for numerator compliance, irrespective of payor. As an example, should a patient be screened for depression and their payor was Aetna at the time of the screening, and then they subsequently become covered by MediCal, we should count the original screen if done during the performance year. We believe the specifications are silent on this type of example. However, we feel this aligns with the state’s goal of ensuring the screening and care for patients with depression and the goal to reduce the burden of healthcare across the state. Specifically, we shouldn’t expect a patient to come back into care specifically to get screened for depression as a second visit just because their coverage has changed. That would cost the patient time and money, the health system time and money and not advance the goal as written. With those sensitivities in mind, we believe that the patient who has been screened throughout the performance year would be numerator compliant, irrespective of payor at the time of the encounter. Please confirm or advise.