Thank you for your inquiry specific to CMS149v13 (Dementia: Cognitive Assessment). Changes were made to the guidance and logic of this measure during AU2024 (for performance period 2025), to ensure the cognitive assessment takes place after a diagnosis of dementia has been made. The guidance section states: “The measure requires a diagnosis of dementia, which is present before the routine assessment of cognition once in a 12-month period.” The initial population logic requires the diagnosis to overlap the day of "Encounter to Assess Cognition”. For the numerator, the assessment counts if performed during the day of the encounter, or up to 12 months prior to that encounter date. The intent, per the logic, is to not provide numerator credit for assessments occurring after the encounter date. This meets the numerator intent statement as it cites “results reviewed”, which means that results were discussed/reviewed during the encounter during the MP.