CMS 165 and RPM

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
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      Thank you for your inquiry about CMS165v13 (performance period 2025). To clarify, per measure logic, the blood pressure readings in the numerator do not need to be associated with the qualifying encounter in the denominator or any other qualifying encounter. The measure looks for the most recent systolic/diastolic blood pressure reading NOT taken during an acute inpatient stay or an emergency department visit.
       
      Additional guidance on qualifying blood pressure readings can be found in the measure specification's "Guidance" section. Please review the measure specification for further details about measure requirements: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS165v13.html.” If you need assistance reading an eCQM, please refer to the resources available at eCQI Resource Center, such as "Guide for Reading eCQMs" or "Implementation Checklist eCQM Annual Update": https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs.
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      Thank you for your inquiry about CMS165v13 (performance period 2025). To clarify, per measure logic, the blood pressure readings in the numerator do not need to be associated with the qualifying encounter in the denominator or any other qualifying encounter. The measure looks for the most recent systolic/diastolic blood pressure reading NOT taken during an acute inpatient stay or an emergency department visit.   Additional guidance on qualifying blood pressure readings can be found in the measure specification's "Guidance" section. Please review the measure specification for further details about measure requirements: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS165v13.html .” If you need assistance reading an eCQM, please refer to the resources available at eCQI Resource Center, such as "Guide for Reading eCQMs" or "Implementation Checklist eCQM Annual Update": https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs .
    • CMS0165v13

      If there is a qualifying encounter during the measurement period and RPM is being done, is it ok to tie back to the qualifying encounter on 4/30 even if the reading was taken on a later date. Example: qualifying encounter on 4/30 office visit. Patient is set up with RPM and has next reading on 5/17, BP is in control and this reading tracks back to qualifying encounter on 4/30. 

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Meri Pearson (Inactive)
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