Regarding the Numerator requirements for CMS 128v6, the Numerator Definitions state:
Numerator 1: Patients who have received antidepressant medication for at least 84 days (12 weeks) of continuous treatment during the 114-day period following the Index Prescription Start Date.
Numerator 2: Patients who have received antidepressant medication for at least 180 days (6 months) of continuous treatment during the 231-day period following the Index Prescription Start Date.

When testing in Cypress, patient Z1 BH Adult has 210 days of medication and is indicated to only meet Numerator 2. Since the Numerator 1 definition states a patient must have received medication for "at least 84 days" of continuous treatment "during the 114-day period" following IPSD, it seems like the patient would meet BOTH Numerator 1 and Numerator 2. There does not appear to be a cap on the Numerator 1 time period.

I understand the 2 Numerators are defining the Acute Phase and Continuation Phase of treatment. However, it seems like there should be a better-defined time period for Numerator 1 if the intent is not to include patients who have surpassed the >= 84 days requirement into the >= 180 days requirement. Would you please advise if it is correct not to include Numerator 2 patients in Numerator 1 or if the opposite is true? Cypress testing is definitely excluding Numerator 2 patients from Numerator 1. I am attaching the Cypress xml file for the patient here.

Any assistance you can provide is greatly appreciated!

Thank you,
Judi