Thank you for your question. We are interpreting this as a question for CMS506v8, Safe Use of Opioids—Concurrent Prescribing. For CMS506v8, F11.20 and methadone can support the opioid use disorder treatment denominator exclusion, but only when the diagnosis, medication, QDM datatype, and timing all satisfy the published logic. Code presence by itself is not sufficient. For the opioid use disorder treatment exclusion in CMS506v8, the logic requires: A medication in the Medications for Opioid Use Disorder (MOUD) value set, OID 2.16.840.1.113762.1.4.1046.269, represented as either “Medication, Active” or “Medication, Order”; and Either: an active “Diagnosis: Opioid Use Disorder” from OID 2.16.840.1.113762.1.4.1111.171, or an “Intervention, Performed: Opioid Medication Assisted Treatment (MAT)” from OID 2.16.840.1.113762.1.4.1111.177; and The timing relationships specified in the logic between the medication, diagnosis or MAT intervention, and inpatient encounter. Both the OUD diagnosis and MAT intervention are not required; either pathway may qualify when paired with the MOUD medication. QDM v5.6 states that, when a Diagnosis is used with timing relationships, “the criterion is looking for an active diagnosis for the time frame indicated.” The diagnosis timing is represented by its prevalencePeriod, from onset through abatement. Therefore, F11.20 must be available to the measure calculation as a QDM Diagnosis with a usable prevalencePeriod covering the relevant treatment date. QDM defines “Medication, Active” as documenting that the medication is being taken by the patient and uses a relevantdateTime or relevantPeriod. “Medication, Order” documents a request to provide the medication and includes the order’s authordateTime. The CMS506v8 2026 value-set expansion (see at the bottom of this response) confirms the following: F11.20 — Opioid dependence, uncomplicated is a member of the Opioid Use Disorder value set The MOUD value set contains these methadone RxNorm formulation codes: 864706 — methadone hydrochloride 10 mg oral tablet 864714 — methadone hydrochloride 10 mg/mL injectable solution 864718 — methadone hydrochloride 5 mg oral tablet 864761 — methadone hydrochloride 1 mg/mL oral solution 864769 — methadone hydrochloride 2 mg/mL oral solution 864978 — methadone hydrochloride 40 mg tablet for oral suspension 991147 — methadone hydrochloride 10 mg/mL oral solution For the alternative MAT-intervention pathway, SNOMED CT 310653000 — Drug addiction therapy using methadone (regime/therapy) is a member of the Opioid Medication Assisted Treatment value set. The actual medication code supplied to the measure engine must be a member of, or appropriately mapped to, the applicable value set and formulation. The specification does not require a particular narrative phrase, note type, or order-set name. The clinically supported information must be available as the structured QDM data elements referenced by the logic. There is an additional timing consideration specific to CMS506v8. The v8.2 CQL evaluates the start of the medication’s relevantdateTime/relevantPeriod, or the authordateTime when the other timing is unavailable, and requires that point to occur on a day during the inpatient encounter. Therefore, an ongoing methadone therapy whose recorded start precedes admission may not meet the v8 exclusion solely because the medication remains active during the hospitalization. A qualifying medication order authored or started during the hospitalization may meet the exclusion when the corresponding OUD diagnosis or MAT timing also satisfies the CQL. Documentation and coding should reflect the patient’s actual clinical circumstances and should not be added or changed solely to affect measure results. Reference: QDM 5.6: https://ecqi.healthit.gov/sites/default/files/QDM-v5.6-508.pdf CMS506v8 2025-05-08 expansion: https://vsac.nlm.nih.gov/valueset/expansions?pr=ecqm&rel=eCQM%20Update%202025-05-08&q=CMS506v8 [For follow-up questions submitted more than 30 days after the "Solution Posted On" date, please submit a new Jira ticket.]