Thank you for your inquiry regarding CMS137v13 (2025 Performance Period). Numerator 1 requires initiation of treatment, either an intervention or medication for the treatment of SUD within 14 days of a SUD episode. Numerator 2 requires that the engagement treatment occur within 34 days after the day of the initiation treatment. A patient must first meet the criteria for Numerator 1 (Initiation) to be considered for Engagement; therefore, if the patient does not meet initiation criteria, they are not eligible for Numerator 2. We are unable to provide guidance on how these events should be documented in the EHR. We recommend consulting your EHR vendor and clinical partners for documentation practices.   Please refer to the measure specification to review the measure requirements: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS137-v14.0.000-QDM.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 .   For inquiries about CMS quality program reporting requirements please contact the QPP Helpdesk at QPP@cms.hhs.gov .