Thank you for your inquiry regarding CMS131v14 (2026 Performance Period). eCQM measures are designed to use clinical data from structured fields in the EHR, rather than billing or claims data. The logic is specified such that if the providers are sharing an EHR or if data is being shared through Health Information Exchange, all providers that have access to the data would receive credit. To fulfill the criteria for this measure, ensure documentation aligns with the measure requirements and is recorded within the EHR. The measure looks for diabetic patients aged 18-75 who had an outpatient visit during the measurement period and received a retinal or dilated eye exam, based on whether they had retinopathy diagnosed during the period or within the previous year. Documentation should include exam details, date, results, and confirmation by an ophthalmologist or optometrist. Exams conducted externally must be recorded in the EHR using a SNOMEDCT code from the "Retinal or Dilated Eye Exam" value set. However, external results not documented in the EHR will not satisfy the measure criteria, regardless of where the exams were performed. 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 . For inquiries about CMS quality program reporting requirements or other quality measure collection types (e.g., MIPS CQM), please contact the QPP Helpdesk at QPP@cms.hhs.gov .