| Title |
Follow-Up Care for Children Prescribed ADHD Medication (ADD)
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Follow-Up Care for Children Prescribed ADHD Medication (ADD)
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Follow-Up Care for Children Prescribed ADHD Medication (ADD)
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| CMS eCQM ID |
CMS136v10
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CMS136v11
|
CMS136v12
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| NQF Number |
Not Applicable
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Not Applicable
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Not Applicable
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| Description |
Percentage of children 6-12 years of age and newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported.
a. Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.
b. Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.
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Percentage of children 6-12 years of age and newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported.
a. Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.
b. Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.
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Percentage of children 6-12 years of age and newly prescribed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported.
a. Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.
b. Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.
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| Initial Population |
Initial Population 1: Children 6-12 years of age who were dispensed an ADHD medication during the Intake Period and who had a visit during the measurement period.
Initial Population 2: Children 6-12 years of age who were dispensed an ADHD medication during the Intake Period and who remained on the medication for at least 210 days out of the 300 days following the IPSD, and who had a visit during the measurement period.
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Initial Population 1: Children 6-12 years of age who were dispensed an ADHD medication during the Intake Period and who had a visit during the measurement period.
Initial Population 2: Children 6-12 years of age who were dispensed an ADHD medication during the Intake Period and who remained on the medication for at least 210 days out of the 300 days following the IPSD, and who had a visit during the measurement period.
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Initial Population 1: Children 6-12 years of age as of the Intake Period who were prescribed an ADHD medication during the Intake Period and who had a visit during the measurement period. Children are removed if they were actively on ADHD medication in the 120 days prior to the IPSD, or had an acute inpatient stay with a principal diagnosis of mental, behavioral or neurodevelopmental disorder during the Initiation Phase.
Initial Population 2: Children 6-12 years of age as of the Intake Period who were prescribed an ADHD medication during the Intake Period and remained on the medication for at least 210 days during the 301-day period, beginning on the IPSD through 300 days after the IPSD, and who had a visit during the measurement period. Children are removed if they were actively on ADHD medication in the 120 days prior to the IPSD, or had an acute inpatient stay with a principal diagnosis of mental, behavioral or neurodevelopmental disorder during the Continuation and Maintenance Phase.
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| Denominator |
Equals Initial Population
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Equals Initial Population
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Equals Initial Population
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| Denominator Exclusions |
Denominator Exclusion 1: Exclude patients diagnosed with narcolepsy at any point in their history or during the measurement period.
Exclude patients who had an acute inpatient stay with a principal diagnosis of mental health or substance abuse during the 30 days after the IPSD.
Exclude patients who were actively on an ADHD medication in the 120 days prior to the Index Prescription Start Date.
Exclude patients whose hospice care overlaps the measurement period.
Denominator Exclusion 2: Exclude patients diagnosed with narcolepsy at any point in their history or during the measurement period.
Exclude patients who had an acute inpatient stay with a principal diagnosis of mental health or substance abuse during the 300 days after the IPSD.
Exclude patients who were actively on an ADHD medication in the 120 days prior to the Index Prescription Start Date.
Exclude patients whose hospice care overlaps the measurement period.
|
Denominator Exclusion 1: Exclude patients diagnosed with narcolepsy at any point in their history or during the measurement period.
Exclude patients who had an acute inpatient stay with a principal diagnosis of mental health or substance abuse during the 30 days after the IPSD.
Exclude patients who were actively on an ADHD medication in the 120 days prior to the Index Prescription Start Date.
Exclude patients who are in hospice care for any part of the measurement period.
Denominator Exclusion 2: Exclude patients diagnosed with narcolepsy at any point in their history or during the measurement period.
Exclude patients who had an acute inpatient stay with a principal diagnosis of mental health or substance abuse during the 300 days after the IPSD.
Exclude patients who were actively on an ADHD medication in the 120 days prior to the Index Prescription Start Date.
Exclude patients who are in hospice care for any part of the measurement period.
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Exclude patients diagnosed with narcolepsy at any point in their history or during the measurement period.
Exclude patients who are in hospice care for any part of the measurement period.
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| Numerator |
Numerator 1: Patients who had at least one face-to-face visit with a practitioner with prescribing authority within 30 days after the IPSD.
Numerator 2: Patients who had at least one face-to-face visit with a practitioner with prescribing authority during the Initiation Phase, and at least two follow-up visits during the Continuation and Maintenance Phase. One of the two visits during the Continuation and Maintenance Phase may be a telephone visit with a practitioner.
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Numerator 1: Patients who had at least one visit with a practitioner with prescribing authority within 30 days after the IPSD.
Numerator 2: Patients who had at least one visit with a practitioner with prescribing authority during the Initiation Phase, and at least two follow-up visits during the Continuation and Maintenance Phase.
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Numerator 1: Patients who had at least one visit with a practitioner with prescribing authority during the Initiation Phase.
Numerator 2: Patients who had at least one visit with a practitioner with prescribing authority during the Initiation Phase, and at least two follow-up visits during the 31-300 days after the IPSD.
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| Numerator Exclusions |
Not Applicable
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Not Applicable
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Not Applicable
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| Denominator Exceptions |
None
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None
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None
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| Measure Steward |
National Committee for Quality Assurance
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National Committee for Quality Assurance
|
National Committee for Quality Assurance
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| Measure Scoring |
Proportion measure
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Proportion measure
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Proportion measure
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| Measure Type |
Process measure
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Process measure
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Process measure
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| Improvement Notation |
Higher score indicates better quality
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Higher score indicates better quality
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Higher score indicates better quality
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| Guidance |
CUMULATIVE MEDICATION DURATION is an individual's total number of medication days over a specific period; the period counts multiple prescriptions with gaps in between, but does not count the gaps during which a medication was not dispensed.
To determine the cumulative medication duration, determine first the number of the medication Days for each prescription in the period: the number of doses divided by the dose frequency per day. Then add the Medication Days for each prescription without counting any days between the prescriptions.
For example, there is an original prescription for 30 days with 2 refills for thirty days each. After a gap of 3 months, the medication was prescribed again for 60 days with 1 refill for 60 days. The cumulative medication duration is (30 x 3) + (60 x 2) = 210 days over the 10 month period.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.
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This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.
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This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
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| MIPS Quality ID |
366
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366
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366
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| Telehealth Eligible |
Yes
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Yes
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Yes
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| Next Version |
CMS136v11
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CMS136v12
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No Version Available
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| Previous Version |
No Version Available
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