Thank you for inquiring about the Preventive Care and Screening: Screening for Depression and Follow-Up Plan eCQM. Please note that the measure is not prescriptive as to which tools may be used to screen for depression, but rather only requires that providers use “A normalized and validated depression screening tool developed for the patient population in which it is being utilized” (eCQM Definition section). The list contained within the v14 specification is not all-encompassing. We are not able to provide guidance on which depression screening tool(s) to use. However, we encourage providers to use their best clinical judgment. You may want to confirm from available literature whether the PHQ-4 is normalized, validated, and has clear guidance on whether a particular score is considered positive for depression. If it meets these criteria, then it may be used to evaluate the measure’s performance.