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  2. CQM-7150

2025 eCQM CMS22

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
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      Thanks for your inquiry on CMS22v13, Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented. CMS22 is an episode-based measure and is reported for every visit.

      In the provided scenario, the visit with Provider A would meet the numerator criteria (as both the systolic and diastolic blood pressure are below the thresholds of: “Systolic BP (SBP) < 120 mmHg AND Diastolic BP (DBP) < 80 mmHg)”.

      The visit with Provider B would not meet the numerator unless there was a referral to an alternate or primary care health care professional, or “ follow-up rescreen [of the patient’s blood pressure] within four weeks; AND recommendation of nonpharmacologic interventions”. We hope this helps clarify your question.
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      Thanks for your inquiry on CMS22v13, Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented. CMS22 is an episode-based measure and is reported for every visit. In the provided scenario, the visit with Provider A would meet the numerator criteria (as both the systolic and diastolic blood pressure are below the thresholds of: “Systolic BP (SBP) < 120 mmHg AND Diastolic BP (DBP) < 80 mmHg)”. The visit with Provider B would not meet the numerator unless there was a referral to an alternate or primary care health care professional, or “ follow-up rescreen [of the patient’s blood pressure] within four weeks; AND recommendation of nonpharmacologic interventions”. We hope this helps clarify your question.
    • CMS0022v13

      As per 2025 measure specifications for CMS22, the release note mentions of "Replaced 'same day as start of' with 'during' and removed 'ends'; added 'day of' to encounter to account for visits spanning more than one day". 

      Based on this change, comparing the specifications from 2024 to 2025, it is now looking for Last BP during the DAY of encounter, instead of during the encounter.

      And this is for Normal BP, elevated BP, First or second hypertensive BP. 

      In an example scenario:
      The patient visits 2 providers on same day.

      Provider A: 8/1/2024 8:00-8:30 AM - Valid visit code with normal BP 90/70.
      Provider B: 8/1/2024 3:00-3:30 PM - Valid visit code with abnormal BP 130/80 and no followup.

       

      Question1: As per 2025 specifications, now we need to consider the LAST BP during the DAY of the encounter. And in this situation, this would be 130/80 which is abnormal BP with no followup for both providers and both dont meet numerator criteria.

      Do we understand this correctly, please clarify. Thank you

       

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            edave Mathematica EC eCQM Team
            priyankamurthy Priyanka Murthy
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