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Primary Caries Prevention Intervention as Offered by Dentists

Measure Information
eCQM Compare View

Compare Versions of: "Primary Caries Prevention Intervention as Offered by Dentists"

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Table Options
Measure Information 2023 Performance Period 2024 Performance Period 2025 Performance Period 2026 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 Primary Caries Prevention Intervention as Offered by Dentists
CMS eCQM ID CMS74v12 CMS74v13 CMS74v14 CMS74v15
CBE ID* Not Applicable Not Applicable Not Applicable Not Applicable
MIPS Quality ID 379 379 379 379
Measure Steward Centers for Medicare & Medicaid Services (CMS) 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

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 Proportion measure
Measure Type Process 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

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

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).

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).

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).

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).

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).

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).

The American Academy of Pediatric Dentistry (AAPD) recommends the application of topical fluoride treatments at least twice per year to reduce the incidence of dental caries, with precise timing based upon the unique needs, risks, and benefits inherent to the individual patient (AAPD, 2023).

Improvement Notation

A higher score indicates better quality

A higher score indicates better quality

A higher score indicates better quality

A higher score indicates better quality

Definition *See CMS74v12.html

None

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.

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.

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.

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.

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

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

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

Exclude patients who are in hospice care or have a hospice care order documented during 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

Children who receive two fluoride varnish applications on different days during the measurement period

Numerator Exclusions

Not Applicable

Not Applicable

Not Applicable

None

Denominator Exceptions

None

None

None

None

Telehealth Eligible No No No No
Next Version No Version Available
Previous Version No Version Available
Specifications and Data Elements
General eCQM Information
Release Notes
General eCQM Information

Header

TRN

Measure Section

Source of Change

Changed the 'eCQM Identifier (Measure Authoring Tool)' field name to 'CMS ID' based on tooling updates.

CMS ID

Standards/Technical Update

Updated the eCQM version number.

eCQM Version Number

Annual Update

Updated the generic measurement period from 'January 1, 20XX through December 31, 20XX' to specify 'January 1, 2026 through December 31, 2026' based on tooling updates.

Measurement Period

Standards/Technical Update

Revised Measure Developer to 'American Institutes for Research.'

Measure Developer

Annual Update

Updated copyright.

Copyright

Annual Update

Updated references and measure header to reflect current evidence and new or updated literature.

Multiple Sections

Measure Lead

Updated 'Denominator Exclusions' language to include 'or have a hospice care order documented during any part of the measurement period' to align with measure logic.

Denominator Exclusions

Measure Lead

Changed 'Numerator Exclusions' field to read 'None' instead of 'Not Applicable' when no exclusions are present.

Numerator Exclusions

Standards/Technical Update

Updated grammar, wording, and/or formatting to improve readability and consistency.

Multiple Sections

Annual Update

Logic

TRN

Measure Section

Source of Change

Updated Measure Primary CQL Library Name from 'PrimaryCariesPreventionasOfferedbyDentists' to 'CMS74DentalCariesPreventionQDM' for alignment with the CQL Style Guide.

Definitions

Standards/Technical Update

Updated the version number of the Global Common Functions Library to v9.0.000 and the library name from 'MATGlobalCommonFunctionsQDM' to 'CQMCommonQDM.'

Definitions

Annual Update

Updated the version number of the HospiceQDM library to 7.0.000.

Definitions

Annual Update

Updated the version number of the Global Common Functions Library to v9.0.000 and the library name from 'MATGlobalCommonFunctionsQDM' to 'CQMCommonQDM.'

Functions

Annual Update

Updated the version number of the HospiceQDM library to 7.0.000.

Functions

Annual Update

logic

TRN

Measure Section

Source of Change

Updated Measure Primary CQL Library Name from'PrimaryCariesPreventionasOfferedbyDentists' to 'CMS74DentalCariesPreventionQDM' for alignment with the CQL Style Guide.

Functions

Standards/Technical 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.

TRN

Measure Section

Source of Change

Replaced Value Set 'ONC Administrative Sex' (2.16.840.1.113762.1.4.1) with Value Set 'Federal Administrative Sex' (2.16.840.1.113762.1.4.1021.121) to represent Supplemental Data Element 'SDE Sex' based on revised standards.

Terminology

Standards/Technical Update

Last Updated: May 07, 2025