Thank you for your inquiry regarding CMS966: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). Our understanding is that the patient was received in first ED, and then was transferred to another ED for the PCI procedure. In this scenario, the patient would be included in the measure population for both EDs assuming none of the measure exclusion criteria apply. This measure captures the percentage of ED encounters for patients 18 years and older with a diagnosis of STEMI who received appropriate treatment, defined as fibrinolytic therapy within 30 minutes of ED arrival, PCI 90 minutes of ED arrival, or transfer to Acute Care Facility within 45 minutes of ED arrival. For the first ED, if the patient is discharged to an acute care facility within 45 minutes of ED arrival and documented in the EHR with a discharge position of discharged to an acute care facility, the case will meet the third numerator criteria. For the second ED, if PCI was performed within 90 minutes of arrival and both ED arrival and PCI procedure time are correctly documented in the EHR, the case will meet the second numerator criteria.