CMS 139 - Fall Screening

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
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      Thank you for your inquiry regarding CMS139v14 (2026 Performance Period). This measure looks for the percentage of every patient 65 years of age and older, who had a qualifying encounter visit during the measurement period, and were screened for future fall risk at least once within the measurement period. The measure's numerator looks for documentation of an assessment via QDM datatype "Assessment, Performed" encoded with any of the following codes from the “Falls Screening” value set (2.16.840.1.113883.3.464.1003.118.12.1028) that is performed on a date/time during the measurement period. TCM office visit encounter codes 99495 and 99496 are not included in this measure. We do not consider TCM to be evidence of a fall risk assessment because such an assessment is not required to bill the code. Clinically equivalent services may be mapped to the codes in the value set. If mapping is done, you should maintain documentation in case of a CMS audit.

      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.
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      Thank you for your inquiry regarding CMS139v14 (2026 Performance Period). This measure looks for the percentage of every patient 65 years of age and older, who had a qualifying encounter visit during the measurement period, and were screened for future fall risk at least once within the measurement period. The measure's numerator looks for documentation of an assessment via QDM datatype "Assessment, Performed" encoded with any of the following codes from the “Falls Screening” value set (2.16.840.1.113883.3.464.1003.118.12.1028) that is performed on a date/time during the measurement period. TCM office visit encounter codes 99495 and 99496 are not included in this measure. We do not consider TCM to be evidence of a fall risk assessment because such an assessment is not required to bill the code. Clinically equivalent services may be mapped to the codes in the value set. If mapping is done, you should maintain documentation in case of a CMS audit. 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.
    • CMS0139v14
    • CMS0139v13
    • This could increase our measure performance.

      We found that fall screenings are typically performed in TCM visits. For CMS 139, can TCM office visit encou/nters (99495 and 99496) be considered a qualifying CPT Type?

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Aya Ghazy
            Votes:
            1 Vote for this issue
            Watchers:
            3 Start watching this issue

              Created:
              Updated:
              Resolved: