Thank you for your inquiry regarding CMS165v13 (2025 Performance Period). The measure guidance states to not include BP readings taken during an acute inpatient stay or an ED visit. Acute inpatient stays and ED visits are defined in the measure logic for Qualifying Diastolic Blood Pressure Reading and Qualifying Systolic Blood Pressure Reading using the "Encounter Inpatient" (2.16.840.1.113883.3.666.5.307) and “Emergency Department Evaluation and Management Visit" (2.16.840.1.113883.3.464.1003.101.12.1010). You can review the codes contained within these value sets on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/ . Click on the “Search Value Sets” tab, enter the value set ID and select the correct “Expansion Version” (i.e., eCQM Update 2024-05-02 for 2025 Performance Period) to review codes included in the respective value set. The intent is to exclude BP readings taken during acute inpatient and ED visit settings and not when patient is in observation. For example, you should use the SNOMED codes in the “Encounter Inpatient” value set to exclude BP readings; if SNOMED codes are not natively supported in your system, you may map clinically equivalent acute inpatient services, and if mapping is done, you should maintain documentation in case of a CMS audit. 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 in the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs