Thank you for inquiring about the eCQM. Note that beginning with the v.14 specification, there are no codes in the “Follow Up for Adult Depression” or “Follow Up for Adolescent Depression” value sets that allow for provider self-referral. The measure intends for patients with documented positive depression screening to receive follow-up by a provider for “additional evaluation, pharmacological interventions, or other interventions for the treatment of depression” (Guidance section). If the provider’s self-referral includes one of the allowable measure interventions (e.g., group psychotherapy, because you also provide this), then the referral for group psychotherapy would count as an appropriate follow-up intervention for the numerator compliance.