Anti-depressant Medication Management

Measure Information	2023 Performance Period
CMS eCQM ID	CMS128v11
NQF Number	Not Applicable
Description	Percentage of patients 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment. Two rates are reported. a. Percentage of patients who remained on an antidepressant medication for at least 84 days (12 weeks). b. Percentage of patients who remained on an antidepressant medication for at least 180 days (6 months).
Initial Population	Patients 18 years of age and older as of April 30 of the measurement period who were dispensed antidepressant medications during the Intake Period, and were diagnosed with major depression 60 days prior to, or 60 days after the dispensing event and had a visit 60 days prior to, or 60 days after the dispensing event
Denominator	Equals Initial Population
Denominator Exclusions	Patients who were actively on an antidepressant medication in the 105 days prior to the IPSD. Exclude patients who are in hospice care for any part of the measurement period.
Numerator	Numerator 1: Patients who have received antidepressant medication for at least 84 days (12 weeks) of continuous treatment beginning on the IPSD through 114 days after the IPSD (115 total days). Numerator 2: Patients who have received antidepressant medications for at least 180 days (6 months) of continuous treatment beginning on the IPSD through 231 days after the IPSD (232 total days).
Numerator Exclusions	Not Applicable
Denominator Exceptions	None
Measure Steward	National Committee for Quality Assurance
Quality Domain	Effective Clinical Care
Measure Scoring	Proportion measure
Measure Type	Process measure
Improvement Notation	Higher score indicates better quality
Guidance	To identify new treatment episodes for major depression, there must be a 105-day negative medication history (a period during which the patient was not taking antidepressant medication) prior to the dispensing event associated with the IPSD. 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.
MIPS Quality ID	009
Meaningful Measure	Prevention, Treatment, and Management of Mental Health
Telehealth Eligible	Yes
Next Version	No Version Available
Previous Version	CMS128v10

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Measure Information	2021 Performance Period	2022 Performance Period	2023 Performance Period
Title	Anti-depressant Medication Management	Anti-depressant Medication Management	Anti-depressant Medication Management
CMS eCQM ID	CMS128v9	CMS128v10	CMS128v11
NQF Number	Not Applicable	Not Applicable	Not Applicable
Description	Percentage of patients 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment. Two rates are reported. a. Percentage of patients who remained on an antidepressant medication for at least 84 days (12 weeks). b. Percentage of patients who remained on an antidepressant medication for at least 180 days (6 months).	Percentage of patients 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment. Two rates are reported. a. Percentage of patients who remained on an antidepressant medication for at least 84 days (12 weeks). b. Percentage of patients who remained on an antidepressant medication for at least 180 days (6 months).	Percentage of patients 18 years of age and older who were treated with antidepressant medication, had a diagnosis of major depression, and who remained on an antidepressant medication treatment. Two rates are reported. a. Percentage of patients who remained on an antidepressant medication for at least 84 days (12 weeks). b. Percentage of patients who remained on an antidepressant medication for at least 180 days (6 months).
Initial Population	Patients 18 years of age and older who were dispensed antidepressant medications within 245 days (8 months) prior to the measurement period through the first 120 days (4 months) of the measurement period, and were diagnosed with major depression 60 days prior to, or 60 days after the dispensing event and had a visit 60 days prior to, or 60 days after the dispensing event	Patients 18 years of age and older who were dispensed antidepressant medications within 245 days (8 months) prior to the measurement period through the first 120 days (4 months) of the measurement period, and were diagnosed with major depression 60 days prior to, or 60 days after the dispensing event and had a visit 60 days prior to, or 60 days after the dispensing event	Patients 18 years of age and older as of April 30 of the measurement period who were dispensed antidepressant medications during the Intake Period, and were diagnosed with major depression 60 days prior to, or 60 days after the dispensing event and had a visit 60 days prior to, or 60 days after the dispensing event
Denominator	Equals Initial Population	Equals Initial Population	Equals Initial Population
Denominator Exclusions	Patients who were actively on an antidepressant medication in the 105 days prior to the Index Prescription Start Date. Exclude patients whose hospice care overlaps the measurement period.	Patients who were actively on an antidepressant medication in the 105 days prior to the Index Prescription Start Date. Exclude patients who are in hospice care for any part of the measurement period.	Patients who were actively on an antidepressant medication in the 105 days prior to the IPSD. Exclude patients who are in hospice care for any part of the measurement period.
Numerator	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 medications for at least 180 days (6 months) of continuous treatment during the 231-day period following the Index Prescription Start Date.	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 medications for at least 180 days (6 months) of continuous treatment during the 231-day period following the Index Prescription Start Date.	Numerator 1: Patients who have received antidepressant medication for at least 84 days (12 weeks) of continuous treatment beginning on the IPSD through 114 days after the IPSD (115 total days). Numerator 2: Patients who have received antidepressant medications for at least 180 days (6 months) of continuous treatment beginning on the IPSD through 231 days after the IPSD (232 total days).
Numerator Exclusions	Not Applicable	Not Applicable	Not Applicable
Denominator Exceptions	None	None	None
Measure Steward	National Committee for Quality Assurance	National Committee for Quality Assurance	National Committee for Quality Assurance
Quality Domain	Effective Clinical Care	Effective Clinical Care	Effective Clinical Care
Measure Scoring	Proportion measure	Proportion measure	Proportion measure
Measure Type	Process measure	Process measure	Process measure
Improvement Notation	Higher score indicates better quality	Higher score indicates better quality	Higher score indicates better quality
Guidance	To identify new treatment episodes for major depression, there must be a 105-day negative medication history (a period during which the patient was not taking antidepressant medication) prior to the first dispensing event associated with the Index Episode Start Date (Index Prescription Start Date). 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.	To identify new treatment episodes for major depression, there must be a 105-day negative medication history (a period during which the patient was not taking antidepressant medication) prior to the dispensing event associated with the Index Prescription Start Date. 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.	To identify new treatment episodes for major depression, there must be a 105-day negative medication history (a period during which the patient was not taking antidepressant medication) prior to the dispensing event associated with the IPSD. 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.
MIPS Quality ID	009	009	009
Meaningful Measure	Prevention, Treatment, and Management of Mental Health	Prevention, Treatment, and Management of Mental Health	Prevention, Treatment, and Management of Mental Health
Telehealth Eligible	Yes	Yes	Yes
Next Version	CMS128v10	CMS128v11	No Version Available
Previous Version	No Version Available	CMS128v9	CMS128v10

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Data Element Repository

Data Elements contained within CMS128v11

Value Sets

Value Sets to be used with CMS128v11

Release Notes

CMS128v11-TRN.xlsx

Header

Updated copyright.

Measure Section: Copyright

Source of Change: Annual Update
Updated references.

Measure Section: Reference

Source of Change: Measure Lead
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
Revised age anchor specification by adding 'as of April 30 of the measurement period' to specify that the patient is at least 18 years old relative to the intake period, which aligns more closely with measure intent.

Measure Section: Initial Population

Source of Change: Measure Lead
Updated continuous treatment descriptions to clarify that treatment timeframes also include IPSD as specified in the logic.

Measure Section: Multiple Sections

Source of Change: Measure Lead
Revised text to refer to 'Index Prescription Start Date' as 'IPSD' after the acronym is first defined to improve readability.

Measure Section: Multiple Sections

Source of Change: Measure Lead
Updated the rationale based on updated evidence to support the measure intent.

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
Added definition of 'Intake Period' and applied the term across the specification 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 number of the Hospice Library to v4.0.000.

Measure Section: Logic

Source of Change: Measure Lead
Added Cumulative Medication Duration Library v1.0.000.

Measure Section: Logic

Source of Change: Measure Lead
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: 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
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
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
Added 'let' statements to define 'IPSD' to improve logic readability.

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
Added the 'NormalizeInterval' function to QDM datatype 'Medication, Dispensed' to decrease implementation burden due to variable use of timing attributes.

Measure Section: Multiple Sections

Source of Change: Measure Lead
Added definition of 'Intake Period' and applied the definition across specification to improve readability.

Measure Section: Multiple Sections

Source of Change: Measure Lead
Revised the age anchor from the start of the measurement period to the end of the intake period, or 'April 30 of the measurement period', to specify that the patient is at least 18 years old relative to the intake period, rather than the measurement period, which aligns more closely with measure intent.

Measure Section: Multiple Sections

Source of Change: Measure Lead
Replaced QDM datatype 'Medication, Active' with 'Medication, Dispensed' and revised logic to more accurately compute medication duration based on stakeholder feedback.

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.

Added direct reference code SNOMED CT code (225754004) 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 (396127008) 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 (307470009) 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 (396125000) 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 (225752000) 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 (307439001) 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 (396108002) 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 (229797004) 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 (396109005) 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 (396107007) 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 (229798009) 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 (229799001) 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 (396126004) based on review by technical experts, SMEs, and/or public feedback.

Measure Section: Terminology

Source of Change: Measure Lead
Value set (2.16.840.1.113883.3.526.3.1492): Renamed to Psych Visit Diagnostic Evaluation based on recommended value set naming conventions.

Measure Section: Terminology

Source of Change: Annual Update
Added direct reference code SNOMED CT code (307468000) 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 (396143001) 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 (225756002) 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 (396131002) 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 (396140003) 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 (307469008) 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
Value set Antidepressant Medication (2.16.840.1.113883.3.464.1003.196.12.1213): Added 11 RxNorm codes (1086789, 1433249, 1653469, 2200168, 2200175, 2200178, 2200181, 251201, 2532159, 2532163, 410584) based on review by technical experts, SMEs, and/or public feedback.

Measure Section: Terminology

Source of Change: Measure Lead
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
Value set (2.16.840.1.113883.3.526.3.1496): Renamed to Psych Visit Psychotherapy based on recommended value set naming conventions.

Measure Section: Terminology

Source of Change: Annual Update
Added direct reference code SNOMED CT code (396111001) based on review by technical experts, SMEs, and/or public feedback.

Measure Section: Terminology

Source of Change: Measure Lead
Value set (2.16.840.1.113883.3.464.1003.101.12.1023): Renamed to Preventive Care Services Initial Office Visit, 18 and Up based on recommended value set naming conventions.

Measure Section: Terminology

Source of Change: Annual Update
Value set (2.16.840.1.113883.3.464.1003.101.12.1025): Renamed to Preventive Care Services Established Office Visit, 18 and Up based on recommended value set naming conventions.

Measure Section: Terminology

Source of Change: Annual Update
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
Added direct reference code SNOMED CT code (396139000) 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