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  1. eCQM Issue Tracker
  2. CQM-7413

Closing the Referral Loop

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    • Mariela Lucaj
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      Thank you for reaching out with your question related to CMS50v12. While this is a patient-based measure, each clinician will need to ensure the referral loop is closed on the first referral for each patient. This is particularly relevant when considering data reporting to CMS for MIPS. For example, if each clinician is reporting data to CMS as an individual, the measure will be reported based on individual performance for the clinicians who choose the measure. If the facility is reporting as a group, the aggregated measure performance of all clinicians billing under your TIN will be reported. In the case of group reporting, the measure will be attributed to every qualifying clinician billing under the TIN. For more information on measure attribution and calculation as it relates to reporting, please refer to Individual or Group Participation (https://qpp.cms.gov/mips/individual-or-group-participation)
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      Thank you for reaching out with your question related to CMS50v12. While this is a patient-based measure, each clinician will need to ensure the referral loop is closed on the first referral for each patient. This is particularly relevant when considering data reporting to CMS for MIPS. For example, if each clinician is reporting data to CMS as an individual, the measure will be reported based on individual performance for the clinicians who choose the measure. If the facility is reporting as a group, the aggregated measure performance of all clinicians billing under your TIN will be reported. In the case of group reporting, the measure will be attributed to every qualifying clinician billing under the TIN. For more information on measure attribution and calculation as it relates to reporting, please refer to Individual or Group Participation ( https://qpp.cms.gov/mips/individual-or-group-participation )
    • CMS0050v12

      I am looking to understand the MIPS eCQM quality measure titled "Closing the Referral Loop: Receipt of Specialist Report" QPPID50. The measure details state the "first referral" is to be evaluated for closing the referral loop. What I am hoping to clarify is whether the "first referral" is specific to the patient OR if it is the first referral a specific provider has written for that patient. Essentially, does the measure follow the patient or can a patient be in two denominators if orders were written by two different providers?

            AIR EC eCQM Team AIR EC eCQM Team
            mlucaj Mariela Lucaj
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