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  1. eCQM Issue Tracker
  2. CQM-7558

CMS 50 v12 Closing the Referral Loop: Receipt of Specialist Report

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
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    • Gayle Poggi
    • 3394999289
    • IHC
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      Thank you for your inquiry regarding CMS50v13 Closing the Referral Loop: Receipt of Specialist Report. As constructed, the measure does not include qualifying encounter codes that a dentist will likely use for directly reporting the measure. Note that the measure guidance indicates: “The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure.” However, if your dental providers do use qualifying encounter codes for their services and plan on reporting the measure to a CMS quality reporting program such as MIPS for 2025 reporting, they must meet the eligibility requirements to participate. These program eligibility requirements are available on CMS’ Quality Reporting site: https://qpp.cms.gov/mips/individual-or-group-participation.
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      Thank you for your inquiry regarding CMS50v13 Closing the Referral Loop: Receipt of Specialist Report. As constructed, the measure does not include qualifying encounter codes that a dentist will likely use for directly reporting the measure. Note that the measure guidance indicates: “The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure.” However, if your dental providers do use qualifying encounter codes for their services and plan on reporting the measure to a CMS quality reporting program such as MIPS for 2025 reporting, they must meet the eligibility requirements to participate. These program eligibility requirements are available on CMS’ Quality Reporting site: https://qpp.cms.gov/mips/individual-or-group-participation .
    • EP
    • CMS0050v13
    • CMS0050v12

      Should this metric include referrals made from just the medical practitioner, or should dental providers who make referrals also be included in it?

      We use this measure for reporting as part of our Patient Centered Medical Home reporting. The name would imply it is for medical practices, however as part of integrated care, should it also include dental providers?

      I ask because we recently opened a dental clinic and are unsure of whether we should be tracking those referrals as well, and if so, if they should be included in our 2025 reporting. 

            AIR EC eCQM Team AIR EC eCQM Team
            gpoggi@ihimv.org Gayle Poggi
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