Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents

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Measure Information	2023 Performance Period	2024 Performance Period	2025 Performance Period
Title	Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents	Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents	Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
CMS eCQM ID	CMS155v11	CMS155v12	CMS155v13
CBE ID*	Not Applicable	Not Applicable	Not Applicable
MIPS Quality ID	239	239	239
Measure Steward	National Committee for Quality Assurance	National Committee for Quality Assurance	National Committee for Quality Assurance
Description	Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period. - Percentage of patients with height, weight, and body mass index (BMI)... percentile documentation - Percentage of patients with counseling for nutrition - Percentage of patients with counseling for physical activity Show more > Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period. - Percentage of patients with height, weight, and body mass index (BMI) percentile documentation - Percentage of patients with counseling for nutrition - Percentage of patients with counseling for physical activity Show less	Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period. - Percentage of patients with height, weight, and body mass index (BMI)... percentile documentation - Percentage of patients with counseling for nutrition - Percentage of patients with counseling for physical activity Show more > Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period. - Percentage of patients with height, weight, and body mass index (BMI) percentile documentation - Percentage of patients with counseling for nutrition - Percentage of patients with counseling for physical activity Show less	Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period. - Percentage of patients with height, weight, and body mass index (BMI)... percentile documentation - Percentage of patients with counseling for nutrition - Percentage of patients with counseling for physical activity Show more > Percentage of patients 3-17 years of age who had an outpatient visit with a primary care physician (PCP) or obstetrician/gynecologist (OB/GYN) and who had evidence of the following during the measurement period. - Percentage of patients with height, weight, and body mass index (BMI) percentile documentation - Percentage of patients with counseling for nutrition - Percentage of patients with counseling for physical activity Show less
Measure Scoring	Proportion measure	Proportion measure	Proportion measure
Measure Type	Process	Process	Process
Stratification	*See CMS155v11.html	Report a total score, and each of the following strata: Stratum 1 - Patients age 3-11 years at the end of the measurement period Stratum 2 - Patients age 12-17 years at the end of the measurement period	Report a total score, and each of the following strata: Stratum 1 - Patients age 3-11 years at the end of the measurement period Stratum 2 - Patients age 12-17 years at the end of the measurement period
Risk Adjustment	*See CMS155v11.html	None	None
Rationale	*See CMS155v11.html	Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be... obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017). Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention, 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (Centers for Disease Control and Prevention, 2016). The direct medical costs associated with childhood obesity total about $19,000 per child, contributing to the $14 billion spent on care related to childhood obesity in the United States (Finkelstein, Graham, & Malhotra, 2014). Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017). Show more > Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017). Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention, 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (Centers for Disease Control and Prevention, 2016). The direct medical costs associated with childhood obesity total about $19,000 per child, contributing to the $14 billion spent on care related to childhood obesity in the United States (Finkelstein, Graham, & Malhotra, 2014). Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017). Show less	Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be... obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017). Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention [CDC], 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (CDC, 2016). The direct medical costs associated with childhood obesity total $1.32 billion per year (Ward et al., 2021). Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017). Show more > Over the last four decades, childhood obesity has more than tripled in children and adolescents 2 to 19 years of age (from a rate of approximately 5 percent to 18.5 percent) (Fryar, Carroll, & Ogden, 2014; Hales et al., 2017). Non-Hispanic black and Hispanic youth are more likely to be obese than their non-Hispanic white and non-Hispanic Asian counterparts. In 2015-2016, approximately 22 percent of non-Hispanic black and 26 percent of Hispanic youth were obese compared to approximately 14 percent of non-Hispanic white and 11 percent of non-Hispanic Asian youth (Hales et al., 2017). Childhood obesity has both immediate and long-term effects on health and well-being. Children who are obese have higher rates of physical health conditions, such as risk factors for cardiovascular disease (like high blood pressure and high cholesterol), type 2 diabetes, asthma, sleep apnea, and joint problems. There is also a correlation between childhood obesity and mental health conditions, such as anxiety and depression (Centers for Disease Control and Prevention [CDC], 2016). In addition, children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, and several types of cancer (CDC, 2016). The direct medical costs associated with childhood obesity total $1.32 billion per year (Ward et al., 2021). Because obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017). Show less
Clinical Recommendation Statement	*See CMS155v11.html	U.S. Preventive Services Task Force (2017) - The Task Force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B... recommendation) American Academy of Pediatrics – Bright Futures (Hagan, Shaw, & Duncan, 2017) - Plot and assess BMI percentiles routinely for early recognition of overweight and obesity. - Assess barriers to healthy eating and physical activity. - Provide anticipatory guidance for nutrition and physical activity. Show more > U.S. Preventive Services Task Force (2017) - The Task Force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation) American Academy of Pediatrics – Bright Futures (Hagan, Shaw, & Duncan, 2017) - Plot and assess BMI percentiles routinely for early recognition of overweight and obesity. - Assess barriers to healthy eating and physical activity. - Provide anticipatory guidance for nutrition and physical activity. Show less	U.S. Preventive Services Task Force (2017) - The Task Force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B... recommendation) American Academy of Pediatrics – Bright Futures (Hagan, Shaw, & Duncan, 2017) - Plot and assess BMI percentiles routinely for early recognition of overweight and obesity. - Assess barriers to healthy eating and physical activity. - Provide anticipatory guidance for nutrition and physical activity. Show more > U.S. Preventive Services Task Force (2017) - The Task Force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation) American Academy of Pediatrics – Bright Futures (Hagan, Shaw, & Duncan, 2017) - Plot and assess BMI percentiles routinely for early recognition of overweight and obesity. - Assess barriers to healthy eating and physical activity. - Provide anticipatory guidance for nutrition and physical activity. Show less
Improvement Notation	Higher score indicates better quality	Higher score indicates better quality	Higher score indicates better quality
Definition	*See CMS155v11.html	None	None
Guidance	The visit must be performed by a PCP or OB/GYN. Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed.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. Show more > The visit must be performed by a PCP or OB/GYN. Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed. 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. Show less	The visit must be performed by a PCP or OB/GYN. Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed.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. Show more > The visit must be performed by a PCP or OB/GYN. Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed. 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. Show less	The visit must be performed by a PCP or OB/GYN. Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed.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. Show more > The visit must be performed by a PCP or OB/GYN. Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed. 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. Show less
Initial Population	Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period	Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period	Patients 3-17 years of age by the end of the measurement period, with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period
Denominator	Equals Initial Population	Equals Initial Population	Equals Initial Population
Denominator Exclusions	Patients who have a diagnosis of pregnancy during the measurement period. Exclude patients who are in hospice care for any part of the measurement period.	Patients who have a diagnosis of pregnancy during the measurement period. Exclude patients who are in hospice care for any part of the measurement period.	Exclude patients who are in hospice care for any part of the measurement period. Patients who have a diagnosis of pregnancy during the measurement period.
Numerator	Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period Numerator 2: Patients who had counseling for nutrition during the measurement period Numerator 3: Patients who had counseling for physical activity during the... measurement period Show more > Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period Numerator 2: Patients who had counseling for nutrition during the measurement period Numerator 3: Patients who had counseling for physical activity during the measurement period Show less	Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period. Numerator 2: Patients who had counseling for nutrition during the measurement period. Numerator 3: Patients who had counseling for physical activity during the... measurement period. Show more > Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period. Numerator 2: Patients who had counseling for nutrition during the measurement period. Numerator 3: Patients who had counseling for physical activity during the measurement period. Show less	Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period. Numerator 2: Patients who had counseling for nutrition during the measurement period. Numerator 3: Patients who had counseling for physical activity during the... measurement period. Show more > Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period. Numerator 2: Patients who had counseling for nutrition during the measurement period. Numerator 3: Patients who had counseling for physical activity during the measurement period. Show less
Numerator Exclusions	Not Applicable	Not Applicable	Not Applicable
Denominator Exceptions	None	None	None
Telehealth Eligible	Yes	Yes	Yes
Next Version	CMS155v12	CMS155v13	No Version Available
Previous Version	No Version Available	CMS155v11	CMS155v12

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Specifications

Additional Resources for CMS155v11

CMS155v11-TRN.xlsx

Header

Updated the description narrative to improve clarity and to align with the measure intent.
Measure Section: Description
Source of Change: Measure Lead
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
Updated version number of the Quality Data Model (QDM) used in the measure specification to v5.6.
Measure Section: Guidance
Source of Change: Standards/Technical Update
Added age anchor specification to the initial population and stratification language to clarify measure requirements.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Updated grammar and punctuation to improve readability.
Measure Section: Multiple Sections
Source of Change: Measure Lead

Logic

Added QDM datatypes Encounter, Performed and Assessment, Performed and associated logic to the Hospice.'Has Hospice Services' definition to provide additional approaches for identifying patients receiving hospice services.
Measure Section: Definitions
Source of Change: Measure Lead
Updated the version of the Quality Data Model (QDM) to 5.6 and Clinical Quality Language (CQL) to 1.5.
Measure Section: Multiple Sections
Source of Change: Standards/Technical Update
Updated the version number of the Hospice Library to v4.0.000.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v7.0.000.
Measure Section: Multiple Sections
Source of Change: Standards/Technical Update
Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.
Measure Section: Multiple Sections
Source of Change: Standards/Technical Update
Replaced the Global.CalendarAgeInYearsAt function with the native CQL function AgeInYearsAt to take advantage of existing CQL features and increase human readability. As a result of this change, the LOINC code 21112-8 is no longer required and has been removed from the Terminology section of the human readable specification.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Revised the initial population and stratifications age anchor from the 'start of the measurement period' to the 'end of the measurement period' to align with the measure intent and CQL style best practices.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Updated the timing precision in the definitions from datetime to date by adding 'day of', 'date from', and/or function 'ToDateInterval' to align with the measure intent.
Measure Section: Multiple Sections
Source of Change: Measure Lead

Value set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

Replaced value set Hospice Care Ambulatory (2.16.840.1.113762.1.4.1108.15) with value set Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set (2.16.840.1.113883.3.464.1003.101.12.1027): Renamed to Preventive Care Services Group Counseling based on recommended value set naming conventions.
Measure Section: Terminology
Source of Change: Annual Update
Value set (2.16.840.1.113883.3.464.1003.101.12.1026): Renamed to Preventive Care Services Individual Counseling based on recommended value set naming conventions.
Measure Section: Terminology
Source of Change: Annual Update
Added value set Hospice Encounter (2.16.840.1.113883.3.464.1003.1003) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed direct reference code LOINC code (21112-8) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Added direct reference code LOINC code (45755-6) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Added direct reference code SNOMED CT code (373066001) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead