Thank you for your inquiry regarding CMS138v13 (2025 Performance Period). The eCQMs are designed to use clinical data from structured fields in the EHR, as opposed to billing/claims data. As specified in the measure logic, visits that would qualify for the Initial Population are those encoded with any codes listed in the value sets from the Qualifying Visit During Measurement Period or the "Preventive Visit During Measurement Period" definitions. To fulfill the criteria for this measure, ensure documentation aligns with the measure requirements and is recorded within the EHR. In your example, if both codes are documented in the EHR on the same day at any time during the measurement period, they may count toward the Initial Population criteria. If you have questions about understanding measure 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 in the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs . For additional guidance regarding MIPS eligibility and participation options, you may submit questions to the QPP helpdesk.