CMS506v7: Safe Use of Opioids measure metrics RY 2025

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Jennifer Marks
    • 484-658-1362
    • St. Luke's University Health Network
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      Thank you for your question regarding CMS506v7 Safe Use of Opioids - Concurrent Prescribing. For "Treatment for Opioid Use Disorders" the logic looks for medications from the "Medications for Opioid Use Disorder (MOUD)" value set (OID 2.16.840.1.113762.1.4.1046.269) that are active or ordered during the day of encounter along with an intervention from the "Opioid Medication Assisted Treatment (MAT)" value set (OID 2.16.840.1.113762.1.4.1111.177) during the day of encounter. Please see the definition for Treatment for Opioid Use disorder found in the definitions section of the measure specifications for the applicable logic:


      Treatment for Opioid Use Disorders

      ( ["Medication, Active": "Medications for Opioid Use Disorder (MOUD)"]
        union ["Medication, Order": "Medications for Opioid Use Disorder (MOUD)"] ) MedicationTreatment
        with ["Intervention, Performed": "Opioid Medication Assisted Treatment (MAT)"] MAT
          such that Coalesce(start of Global."NormalizeInterval"(MedicationTreatment.relevantDatetime, MedicationTreatment.relevantPeriod), MedicationTreatment.authorDatetime) during day of Global."NormalizeInterval" ( MAT.relevantDatetime, MAT.relevantPeriod )
            and Coalesce(start of Global."NormalizeInterval"(MedicationTreatment.relevantDatetime, MedicationTreatment.relevantPeriod), MedicationTreatment.authorDatetime) during day of "Measurement Period"
       

      Patients with opioid use disorder, cancer pain, and sickle cell disease are excluded from this measure to align with the best practices in the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain which states, "This clinical practice guideline is intended for clinicians who are treating outpatients aged ≥18 years with acute (duration of <1 month), subacute (duration of 1–3 months), or chronic (duration of >3 months) pain, and excludes pain management related to sickle cell disease, cancer-related pain treatment, palliative care, and end-of-life care."
      Show
      Thank you for your question regarding CMS506v7 Safe Use of Opioids - Concurrent Prescribing. For "Treatment for Opioid Use Disorders" the logic looks for medications from the "Medications for Opioid Use Disorder (MOUD)" value set (OID 2.16.840.1.113762.1.4.1046.269) that are active or ordered during the day of encounter along with an intervention from the "Opioid Medication Assisted Treatment (MAT)" value set (OID 2.16.840.1.113762.1.4.1111.177) during the day of encounter. Please see the definition for Treatment for Opioid Use disorder found in the definitions section of the measure specifications for the applicable logic: Treatment for Opioid Use Disorders ( ["Medication, Active": "Medications for Opioid Use Disorder (MOUD)"]   union ["Medication, Order": "Medications for Opioid Use Disorder (MOUD)"] ) MedicationTreatment   with ["Intervention, Performed": "Opioid Medication Assisted Treatment (MAT)"] MAT     such that Coalesce(start of Global."NormalizeInterval"(MedicationTreatment.relevantDatetime, MedicationTreatment.relevantPeriod), MedicationTreatment.authorDatetime) during day of Global."NormalizeInterval" ( MAT.relevantDatetime, MAT.relevantPeriod )       and Coalesce(start of Global."NormalizeInterval"(MedicationTreatment.relevantDatetime, MedicationTreatment.relevantPeriod), MedicationTreatment.authorDatetime) during day of "Measurement Period"   Patients with opioid use disorder, cancer pain, and sickle cell disease are excluded from this measure to align with the best practices in the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain which states, "This clinical practice guideline is intended for clinicians who are treating outpatients aged ≥18 years with acute (duration of <1 month), subacute (duration of 1–3 months), or chronic (duration of >3 months) pain, and excludes pain management related to sickle cell disease, cancer-related pain treatment, palliative care, and end-of-life care."
    • EH
    • CMS1206v2
    • CMS0506v6
    • clarification on metrics to ensure proper mapping and reporting

      Could someone please clarify the metrics for CMS506v7 denominator exclusion.  

      In the Measure Flow Diagram on the CMS website the following metric reads:  Treatment for Opioid Use Disorders "with" MAT

      This leads us to believe that the metric reads 1 and 3  OR   2 and 3 as shown below

      The CMS specs sheet for the measure does not call this out specifically:

       Also, how does CMS justify other exclusions (diagnosis of OUD, cancer pain, sickle cell)? If this is to be a patient safety measure, would not all patients be included, regardless of diagnosis? 

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            Assignee:
            Augustine Weber
            Reporter:
            Jennifer Marks (Inactive)
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              Created:
              Updated:
              Resolved: