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  1. eCQM Issue Tracker
  2. CQM-7095

Specialty clinic referrals to primary care

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Icon: Moderate Moderate
    • None
    • None
    • Jennifer Weiss
    • 605.312.6427
    • Sanford Health
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      Thank you for your inquiry into CMS2v13, Preventative Care and Screening: Screening for Depression and Follow-up Plan.

      Referral to Primary Care Service (SNOMEDCT: 703978000) is included in the Referral for Adult Depression (2.16.840.1.113883.3.526.3.1571) and in the Referral for Adolescent Depression (2.16.840.1.113883.3.526.3.1570) value sets within the measure. These value sets are found on The National Library of Medicine's Value Set Authority Center (VSAC), 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. The VSAC provides downloadable access to all official versions of value sets content contained in the eCQM specifications.
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      Thank you for your inquiry into CMS2v13, Preventative Care and Screening: Screening for Depression and Follow-up Plan. Referral to Primary Care Service (SNOMEDCT: 703978000) is included in the Referral for Adult Depression (2.16.840.1.113883.3.526.3.1571) and in the Referral for Adolescent Depression (2.16.840.1.113883.3.526.3.1570) value sets within the measure. These value sets are found on The National Library of Medicine's Value Set Authority Center (VSAC), 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. The VSAC provides downloadable access to all official versions of value sets content contained in the eCQM specifications.
    • CMS0002v13
    • Updating the depression screening value set for referrals from specialty clinics to primary care will ease documentation burden when patients do not have an established primary care clinician.

      Some specialty clinics/eligible clinicians are held accountable for depression screening and follow up.  Clinically, these patients while positive, do not necessarily merit a referral to an already stretched behavioral health specialty.  Many patients would benefit from a referral to establish primary care or advised to schedule an appointment with their established primary care clinician.  The Association of American Medical Colleges (AAMC) reports nearly 60% of patients who receive mental health treatment do so from their PCP.  Adding primary care referrals to the eligible referral value set allows busy specialists to meet the measure through referrals to primary care when a patient isn't established.

            edave Mathematica EC eCQM Team
            weissj Jennifer Weiss
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