Thank you for your inquiry regarding CMS165v13 (2025 Performance Period). In this measure, blood pressure readings performed by the clinical staff, e.g. medical assistant, nurse, nurse practitioner, are qualifying documentation for evaluating numerator compliance. Per guidance in the measure specification, as long as the blood pressure readings are documented in the patient's medical record, as approved by the clinician, then those are acceptable for numerator evaluation. The intent of the guidance is to not include blood pressure readings that are read by or taken by patients.   Additional guidance on qualifying blood pressure readings can be found in the measure specification's "Guidance" section. Please review the measure specification for further details about measure requirements: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS165v13.html . 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 .