Primary Caries Prevention Intervention as Offered by Dentists

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Measure Information	2023 Performance Period	2024 Performance Period	2025 Performance Period
Title	Primary Caries Prevention Intervention as Offered by Dentists	Primary Caries Prevention Intervention as Offered by Dentists	Primary Caries Prevention Intervention as Offered by Dentists
CMS eCQM ID	CMS74v12	CMS74v13	CMS74v14
CBE ID*	Not Applicable	Not Applicable	Not Applicable
MIPS Quality ID	379	379	379
Measure Steward	Centers for Medicare & Medicaid Services (CMS)	Centers for Medicare & Medicaid Services (CMS)	Centers for Medicare & Medicaid Services (CMS)
Description	Percentage of children, 6 months - 20 years of age, who received a fluoride varnish application during the measurement period as determined by a dentist	Percentage of children, 1 - 20 years of age, who received two fluoride varnish applications during the measurement period as determined by a dentist	Percentage of children, 1-20 years of age, who received two fluoride varnish applications during the measurement period as determined by a dentist
Measure Scoring	Proportion measure	Proportion measure	Proportion measure
Measure Type	Process	Process	Process
Stratification	*See CMS74v12.html	Population 1: Patients age 1-5 years at the start of the Measurement Period Population 2: Patients age 6-12 years at the start of the Measurement Period Population 3: Patients age 13-20 years at the start of the Measurement Period	Population 1: Patients age 1-5 years at the start of the Measurement Period Population 2: Patients age 6-12 years at the start of the Measurement Period Population 3: Patients age 13-20 years at the start of the Measurement Period
Risk Adjustment	*See CMS74v12.html	None	None
Rationale	*See CMS74v12.html	The literature reflects that fluoride varnish, when applied to the teeth of high-risk children, reduces, in conjunction with anticipatory guidance provided to the caregiver, the risk of the child developing caries (Weyant et al., 2013). Evidence in the literature also specifically... supports the effectiveness of professionally applied fluoride varnish at preventing caries in higher risk children (Chou et al., 2014). Show more > The literature reflects that fluoride varnish, when applied to the teeth of high-risk children, reduces, in conjunction with anticipatory guidance provided to the caregiver, the risk of the child developing caries (Weyant et al., 2013). Evidence in the literature also specifically supports the effectiveness of professionally applied fluoride varnish at preventing caries in higher risk children (Chou et al., 2014). Show less	The literature reflects that fluoride varnish, when applied to the teeth of high-risk children, reduces, in conjunction with anticipatory guidance provided to the caregiver, the risk of the child developing caries (Weyant et al., 2013). Evidence in the literature also specifically... supports the effectiveness of professionally applied fluoride varnish at preventing caries in higher risk children (Chou et al., 2014). Show more > The literature reflects that fluoride varnish, when applied to the teeth of high-risk children, reduces, in conjunction with anticipatory guidance provided to the caregiver, the risk of the child developing caries (Weyant et al., 2013). Evidence in the literature also specifically supports the effectiveness of professionally applied fluoride varnish at preventing caries in higher risk children (Chou et al., 2014). Show less
Clinical Recommendation Statement	*See CMS74v12.html	The 2013 American Dental Association (ADA) clinical recommendations for use of professionally applied or prescription-strength, home-use topical fluorides for caries prevention in patients at elevated risk of developing caries: - Younger Than 6 Years - 2.26 percent fluoride varnish at... least every three to six months - 6-18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months - Older Than 18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months (Weyant et al., 2013) The United States Preventive Services Taskforce (USPSTF) recommends the use of professionally applied fluoride varnish for the prevention of dental caries in high risk children under 5 years of age (Chou et al., 2014). Show more > The 2013 American Dental Association (ADA) clinical recommendations for use of professionally applied or prescription-strength, home-use topical fluorides for caries prevention in patients at elevated risk of developing caries: - Younger Than 6 Years - 2.26 percent fluoride varnish at least every three to six months - 6-18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months - Older Than 18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months (Weyant et al., 2013) The United States Preventive Services Taskforce (USPSTF) recommends the use of professionally applied fluoride varnish for the prevention of dental caries in high risk children under 5 years of age (Chou et al., 2014). Show less	The 2013 American Dental Association (ADA) clinical recommendations for use of professionally applied or prescription-strength, home-use topical fluorides for caries prevention in patients at elevated risk of developing caries: - Younger Than 6 Years - 2.26 percent fluoride varnish at... least every three to six months. - 6-18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months. - Older Than 18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months (Weyant et al., 2013). The United States Preventive Services Taskforce (USPSTF) recommends the use of professionally applied fluoride varnish for the prevention of dental caries in high risk children under 5 years of age (Chou et al., 2014). Show more > The 2013 American Dental Association (ADA) clinical recommendations for use of professionally applied or prescription-strength, home-use topical fluorides for caries prevention in patients at elevated risk of developing caries: - Younger Than 6 Years - 2.26 percent fluoride varnish at least every three to six months. - 6-18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months. - Older Than 18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months (Weyant et al., 2013). The United States Preventive Services Taskforce (USPSTF) recommends the use of professionally applied fluoride varnish for the prevention of dental caries in high risk children under 5 years of age (Chou et al., 2014). Show less
Improvement Notation	A higher score indicates better quality	A higher score indicates better quality	A higher score indicates better quality
Definition	*See CMS74v12.html	None	None
Guidance	This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer... to the QDM page for more information on the QDM. Show more > This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. Show less	This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer... to the QDM page for more information on the QDM. Show more > This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. Show less	This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer... to the QDM page for more information on the QDM. Show more > This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. 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	Children, 6 months - 20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period	Children, 1 - 20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period	Children, 1-20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period
Denominator	Equals Initial Population	Equals Initial Population	Equals Initial Population
Denominator Exclusions	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	Exclude patients who are in hospice care for any part of the measurement period
Numerator	Children who receive a fluoride varnish application during the measurement period	Children who receive two fluoride varnish applications on different days during the measurement period	Children who receive two fluoride varnish applications on different days during the measurement period
Numerator Exclusions	Not Applicable	Not Applicable	Not Applicable
Denominator Exceptions	None	None	None
Telehealth Eligible	No	No	No
Next Version	CMS74v13	CMS74v14	No Version Available
Previous Version	No Version Available	CMS74v12	CMS74v13

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Additional Resources for CMS74v14

CMS74v14-TRN.xlsx

Header

Updated the eCQM version number.
Measure Section:
eCQM Version Number
Source of Change:
Annual Update
Changed all references from NQF to CBE to identify the consensus-based entity role.
Measure Section:
CBE Number
Source of Change:
Annual Update
Updated copyright.
Measure Section:
Copyright
Source of Change:
Annual Update
Updated grammar, wording, and/or formatting to improve readability and consistency.
Measure Section:
Multiple Sections
Source of Change:
Annual Update

Logic

Renamed value set to 'Payer Type' to more accurately reflect the contents and intent of the value set.
Measure Section:
Definitions
Source of Change:
Standards/Technical Update
Updated the version number of the Hospice Library to v6.0.000 and the library name from 'Hospice' to 'HospiceQDM.'
Measure Section:
Definitions
Source of Change:
Annual Update
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'
Measure Section:
Definitions
Source of Change:
Annual Update
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'
Measure Section:
Functions
Source of Change:
Annual Update

Value Set

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

Value set Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584): Added 2 SNOMED CT codes (170935008, 170936009) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 SNOMED CT code (385765002) based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set (2.16.840.1.114222.4.11.3591): Renamed to Payer Type based on recommended value set naming conventions.
Measure Section:
Terminology
Source of Change:
Annual Update