Thank you for your inquiry regarding CMS122v14 (2026 Performance Period). The denominator for this measure includes patients who have both a qualifying encounter and an active diabetes diagnosis during the measurement period. The diagnosis must be coded using the Diabetes value set (OID: 2.16.840.1.113883.3.464.1003.103.12.1001), and the measure logic requires that the diagnosis overlap the measurement period to qualify for the initial population. No specific lookback period is required. Although diabetes is a chronic condition that typically persists over time, the logic requires that they be active during the measurement period. A diabetes diagnosis that began prior to the measurement period should still be considered active, as these conditions typically do not resolve. Thus, patients with these diagnoses, even if documented before the measurement year, should be counted since these conditions do not have an end date, ensuring overlap with the measurement period. However, if the diagnosis onset and abatement dates fall entirely outside of the measurement period, the patient would not meet the criteria. The data must be entered and documented into an EHR. 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 or other quality measure collection types (e.g., MIPS CQM), please contact the QPP Helpdesk at QPP@cms.hhs.gov .