Thank you for your inquiry about CMS165v13 (performance period 2025). To clarify, per measure logic, blood pressure readings used to satisfy the numerator criteria do not need to be associated with the qualifying encounter in the denominator or to any other qualifying encounter. The measure looks for the most recent documented systolic/diastolic blood pressure readings, excluding those taken during an acute inpatient stay or an emergency department visit. In your example, if provider A and B see the same patient and have shared EHR, and that the patient's most recent qualifying blood pressure recorded in EHR is controlled within range, the patient is expected to be included in the numerator for both providers. Conversely, if the patient's most recent qualifying blood pressure is not controlled within range, the patient should not be included in the numerator for both providers. 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 .