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Type: Hosp Outpt eCQMs - Hospital Outpatient eCQMs
Resolution: Answered
Priority: Blocker
Component/s: None
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Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). The measure excludes encounters with documentation of hospice services in the six months within the start of the ED encounter, or active hospice status at the start of the ED encounter, as captured by the hospice definition included in the inquiry. We confirm that your understanding of the hospice definition is correct. Encounters in which the Result attribute of the “Assessment, Performed”: “Hospice Care [Minimum Data Set]” datatype is “Yes (qualifier value)” as indicated by SNOMEDCT Code: 373066001, can have one of two timing components to be captured in the measure:

1) The relevant dateTime attribute (which references timing for an assessment that occurs at a single point in time) of the hospice assessment should occur six months or less before the start of the ED encounter relevantPeriod (or the time the encounter began to the time the encounter ended)

OR

2) The relevantPeriod of the hospice assessment (or the start and stop time for an assessment that occurs over a time interval) should overlap six months or less before the start of the ED encounter relevantPeriod to the end of the ED encounter relevantPeriod.

Overall, the logic in the inquiry indicates that patients can be excluded from the measure denominator if they have an assessment that indicates they have received hospice care in the prior six months. Please work with your EHR vendor to ensure that assessment items indicating hospice care are mapped to the “Assessment, Performed” QDM datatype and the Result attribute.

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Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). The measure excludes encounters with documentation of hospice services in the six months within the start of the ED encounter, or active hospice status at the start of the ED encounter, as captured by the hospice definition included in the inquiry. We confirm that your understanding of the hospice definition is correct. Encounters in which the Result attribute of the “Assessment, Performed”: “Hospice Care [Minimum Data Set]” datatype is “Yes (qualifier value)” as indicated by SNOMEDCT Code: 373066001, can have one of two timing components to be captured in the measure: 1) The relevant dateTime attribute (which references timing for an assessment that occurs at a single point in time) of the hospice assessment should occur six months or less before the start of the ED encounter relevantPeriod (or the time the encounter began to the time the encounter ended) OR 2) The relevantPeriod of the hospice assessment (or the start and stop time for an assessment that occurs over a time interval) should overlap six months or less before the start of the ED encounter relevantPeriod to the end of the ED encounter relevantPeriod. Overall, the logic in the inquiry indicates that patients can be excluded from the measure denominator if they have an assessment that indicates they have received hospice care in the prior six months. Please work with your EHR vendor to ensure that assessment items indicating hospice care are mapped to the “Assessment, Performed” QDM datatype and the Result attribute.
2026 Reporting Period Hosp Outpt eCQMs:

CMS0996v6

Hi Team,

We have a query for ( ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment logic from the
mentioned denominator exclusion criteria:

ED Encounter With Hospice Services
from "ED Encounter With STEMI Diagnosis" EDwSTEMI
let SixMonthsBeforeToEndOfSTEMI: Interval[start of EDwSTEMI.relevantPeriod - 6 months, end of EDwSTEMI.relevantPeriod]
where (
exists ( ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter
where ( InpatientEncounter.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or InpatientEncounter.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)")
and ( Global."HasStart" ( InpatientEncounter.relevantPeriod )
and InpatientEncounter.relevantPeriod overlaps day of SixMonthsBeforeToEndOfSTEMI
)
)
or exists ( ["Encounter, Performed": "Hospice Encounter"] HospiceEncounter
where ( Global."HasStart" ( HospiceEncounter.relevantPeriod )
and HospiceEncounter.relevantPeriod overlaps day of SixMonthsBeforeToEndOfSTEMI
)
)
or exists ( ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment
where (HospiceAssessment.result ~ "Yes (qualifier value)"
and (HospiceAssessment.relevantDatetime 6 months or less before start of EDwSTEMI.relevantPeriod
or (Global."HasStart" ( HospiceAssessment.relevantPeriod )
and HospiceAssessment.relevantPeriod overlaps day of SixMonthsBeforeToEndOfSTEMI
)
)
)
)
or exists ( ["Intervention, Order": "Hospice Care Ambulatory"] HospiceOrder
where (HospiceOrder.authorDatetime 6 months or less before start of EDwSTEMI.relevantPeriod )
)
or exists ( ["Intervention, Performed": "Hospice Care Ambulatory"] HospicePerformed
where (HospicePerformed.relevantDatetime 6 months or less before start of EDwSTEMI.relevantPeriod or
(Global."HasStart" ( HospicePerformed.relevantPeriod )
and HospicePerformed.relevantPeriod overlaps day of SixMonthsBeforeToEndOfSTEMI
)
)
)
or exists ( ["Diagnosis": "Hospice Diagnosis"] HospiceCareDiagnosis
where ( HospiceCareDiagnosis.prevalencePeriod ends on or after start of EDwSTEMI.relevantPeriod )
)
)

Query:
We understand ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment can be validated in two ways in OR logic:
a)HospiceAssessment.relevantDatetime 6 months or less before start of EDwSTEMI.relevantPeriod
or
b)Global."HasStart" (HospiceAssessment.relevantPeriod)and HospiceAssessment.relevantPeriod overlaps day of SixMonthsBeforeToEndOfSTEMI

If either of the validation is satisfied Patient qualifies for denominator exclusion.
Kindly confirm if our understanding is correct.

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