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Type:
EC eCQMs - Eligible Clinicians
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Resolution: Answered
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Priority:
Moderate
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Component/s: None
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None
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Andrea Howard
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2814667590
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McKesson
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CMS0002v15
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CMS0002v14
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We need clarifying information on the below scenarios.
Good afternoon,
I am writing this question on behalf of Practice Insights QCDR regarding MIPS 134 Depression (MIPS eCQM version specification).
We understand that MIPS 134 is a patient-based measure where the intended Can you please clarify the measure performance calculation may differ for clinicians at the same practice, given the following scenario:
The patient, Sammy Smith, is cared for by multiple physicians during the year at Apha Oncology Clinic.
- Physician A sees Sammy for a qualifying E/M visit in Feb 2025 and does not complete a depression screen.
- Physician B sees Sammy for a qualifying E/M visit in June 2025 and completes a depression screen. The screen is negative. Physician C also sees Sammy on the same day for a qualifying E/M visit and does not complete a depression screen because she sees in the EHR that one was completed earlier in the day by Physician B.
- Physician D sees Sammy for a qualifying E/M visit in Sept 2025 and does not complete a depression screen because the patient’s medical record indicates that a depression screen was already completed by Physician B in June and the result was negative.
- Physician E sees Sammy for a qualifying E/M visit in Nov 2025 and the patient refuses to complete a depression screen and this is recorded as a Denominator Exception.
For Individual Clinician MIPS Reporting:
- Which Physicians should receive numerator credit for MIPS 134?
- Does CMS expect the patient to be screened 5 times during 2025 because he was seen by 5 different physicians at Alpha Oncology Clinic OR can a completed depression screen be referenced for each of the physicians who have had a qualifying E/M with Sammy?
- Which physicians should have the patient qualify for a Denominator Exception due to the patient refusal to complete the depression screen?
For the Group MIPS Reporting:
- Should Sammy be considered Numerator Met because the Depression Screen was completed in June 2025 OR should Sammy be considered a Denominator Exception because the most recent screening attempt resulted in a patient refusal?
Thank you in advance for clarifying these scenarios.
Andrea Howard