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  2. CQM-7329

CMS2v13 Telephone Encounters

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Icon: Moderate Moderate
    • None
    • None
    • Amelia Reynoldson
    • 843-343-6145
    • Medical University of South Carolina
    • Hide
      Documentation of a telehealth encounter code from the “Telehealth Visits” value set (2.16.840.1.113883.3.464.1003.101.12.1080) in the patient’s record would meet the Denominator’s qualifying encounter requirement. Please note the measure logic does not differentiate between in-person encounters or telehealth encounters when determining if all the other aspects of the quality action within the measure specification were met. In other words, whether the encounter is in person or via telehealth, the measure’s quality actions are the eligible clinicians' responsibility. If the Case Manager / nurse mentioned in your inquiry is a MIPS eligible clinician, they may perform, via a telehealth encounter, the quality actions necessary to meet the numerator. For further information on MIPS eligible clinician types and requirements, please refer to the information located on the Quality Payment Program website: https://qpp.cms.gov/mips/how-eligibility-is-determined#mips-eligible-clinician-types. Thank you.
      Show
      Documentation of a telehealth encounter code from the “Telehealth Visits” value set (2.16.840.1.113883.3.464.1003.101.12.1080) in the patient’s record would meet the Denominator’s qualifying encounter requirement. Please note the measure logic does not differentiate between in-person encounters or telehealth encounters when determining if all the other aspects of the quality action within the measure specification were met. In other words, whether the encounter is in person or via telehealth, the measure’s quality actions are the eligible clinicians' responsibility. If the Case Manager / nurse mentioned in your inquiry is a MIPS eligible clinician, they may perform, via a telehealth encounter, the quality actions necessary to meet the numerator. For further information on MIPS eligible clinician types and requirements, please refer to the information located on the Quality Payment Program website: https://qpp.cms.gov/mips/how-eligibility-is-determined#mips-eligible-clinician-types . Thank you.
    • EP
    • CMS0002v13
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      For CMS2v13, Telephone Encounters are listed as an eligible encounter. I'm wanting to ensure I understand the intent of this. Would a Case Manager reaching out to a patient for care gap closures, performing a depression screening, and documenting any necessary follow up during a telephone encounter place that patient in the Denominator and/or Numerator? This would be a nurse acting on behalf of a provider and would not be a billable code. Thanks!
      Show
      For CMS2v13, Telephone Encounters are listed as an eligible encounter. I'm wanting to ensure I understand the intent of this. Would a Case Manager reaching out to a patient for care gap closures, performing a depression screening, and documenting any necessary follow up during a telephone encounter place that patient in the Denominator and/or Numerator? This would be a nurse acting on behalf of a provider and would not be a billable code. Thanks!

      Currently, our teams are doing telephonic outreach to close care gaps. We don't have telephone outreach encounters mapped for CMS2 as we are unclear on the intent of including telephone encounters. 

            AIR EC eCQM Team AIR EC eCQM Team
            awreynoldson Amelia Reynoldson
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