CMS50v13 Referral Criteria

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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    • John Buen
    • Buenj
    • 347 931 1615
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      Thank you for inquiring about the Closing the Referral Loop: Receipt of Specialist Report eCQM. The measure is not prescriptive as to the referral provider. The value set “Referral" includes a concept for "Patient referral to non-physician provider (procedure)” (SNOMED-CT 103698003). Therefore, the referenced nurse visits and social work referrals would apply to this code.
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      Thank you for inquiring about the Closing the Referral Loop: Receipt of Specialist Report eCQM. The measure is not prescriptive as to the referral provider. The value set “Referral" includes a concept for "Patient referral to non-physician provider (procedure)” (SNOMED-CT 103698003). Therefore, the referenced nurse visits and social work referrals would apply to this code.
    • CMS0050v13
    • We want to ensure we are tracking this measure intends to consider as a referral.

      Can you confirm if Nurse visits (ie RN visits) count as a referral. Those are not visits where we are looking for specialist advise. Rather they are implementing a plan by the PCP.

      Same question for Social Work. (Not Psychiatry or Mental health)

            Assignee:
            AIR EC eCQM Team
            Reporter:
            John-Conrad
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