Thank you for your inquiry regarding CMS154v13 (2025 Performance Period). The eCQM measures are designed to use clinical data from structured fields in the EHR, rather than billing or claims data. Clinically equivalent services can be mapped to the measure's value sets. If mapping is done, you should maintain documentation in case of a CMS audit. The eCQM measures do not reference modifiers because codes in the value sets meet criteria regardless of whether or not a modifier is present (unless a measure specification states otherwise). You may reference the "Telehealth Guidance for eCQMs for Eligible Clinician Quality Reporting" for additional guidance: https://ecqi.healthit.gov/sites/default/files/2025-EC-Telehealth-Guidance.pdf . If you have questions about reading the measure specification or understanding data requirements, you may refer to the "Guide for Reading eCQMs" for additional guidance. If you have questions regarding implementing the measure, you may refer to the "Implementation Checklist for eCQM Annual Update" for additional guidance. These resources can be found on the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs

Billing has set up custom codes for virtual encounters - they are using .TH tagged on at the end of the approved codes, from this value set 2.16.840.1.113883.3.464.1003.101.12.1089, to flag our EHR to update the modifier on the claim. However, the encounters are not included in the eCQM reporting because of the .TH.