• Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
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      Thank you for your inquiry regarding CMS137v13 (2025 Performance Period). To be eligible for Numerator 2, the patient must first meet the criteria for Numerator 1 (Initiation). Engagement treatment must then occur within 34 days after the day of the initiation treatment.

      In the scenario provided, the patient does not meet Numerator 2 requirements. Although the patient has one non medication intervention and one short acting medication event within the 34 day window, the initiation criteria are not met in a way that supports progression to engagement as defined for Numerator 2.
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      Thank you for your inquiry regarding CMS137v13 (2025 Performance Period). To be eligible for Numerator 2, the patient must first meet the criteria for Numerator 1 (Initiation). Engagement treatment must then occur within 34 days after the day of the initiation treatment. In the scenario provided, the patient does not meet Numerator 2 requirements. Although the patient has one non medication intervention and one short acting medication event within the 34 day window, the initiation criteria are not met in a way that supports progression to engagement as defined for Numerator 2.
    • CMS0137v14
    • CMS0137v13
    • CMS0137v12

      Need Clarification on Numerator 2
      In the following scenario 
      Patient has an Office visit with SUD 1/1/xxxx 
      2 days after intial SUD patient has non-medication intervention so 1/3/xxxx
      then 30 days after the SUD patient gets prescribed Short- acting medication on 1/30/xxxx
      Would the patient qualify for Numerator 2 since it meets option 2 (highlighted in Bold)  or would it require a second non-medication intervention as described in the Data Criteria section of 2 medications OR 2 non Medications Interventions

      so my question is which set of data do I go with c) one engagement visit and one engagement medication treatment event. OR

      or "Has Two or More Treatment Engagements With Short Acting Medication or Non Medication Intervention"

      According to the ECQM s

      Numerator 2: Engagement in ongoing SUD treatment within 34 days of initiation includes: 1. A long-acting SUD medication on the day after the initiation through 34 days after the initiation of treatment. 2. One of the following options on the day after the initiation of treatment through 34 days after the initiation of treatment: a) two engagement visits, b) two engagement medication treatment events, c) one engagement visit and one engagement medication treatment event.

      But in the Data Criteria sections I see something that appears to contradict the narrative for Numerator 2

      Numerator 2

      • "Has Treatment Engagement With Long Acting Medication"
        or "Has Two or More Treatment Engagements With Short Acting Medication or Non Medication Intervention"

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Nancy B Layko
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