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HIV Viral Suppression

Compare Versions of: "HIV Viral Suppression"

The Compare function compares two years of the measure specifications found in the header of the measure's HTML. It does not include a comparison of any information in the body of the HTML, e.g., population criteria, Clinical Quality Language, or value sets.

Strikethrough text highlighted in red indicates information changed from the previous version. Text highlighted in green indicates information updated in the new eCQM version.

Compare 2026 version to

Table Options
Measure Information 2026 Performance Period
Title HIV Viral Suppression
CMS eCQM ID CMS314v3
CBE ID* Not Applicable
MIPS Quality ID 338
Measure Steward Health Resources & Services Administration
Description

Percentage of patients, regardless of age, diagnosed with Human Immunodeficiency Virus (HIV) prior to or during the first 90 days of the measurement period, with an eligible encounter in the first 240 days of the measurement period, whose last HIV viral load test result was less than 200...

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Measure Scoring Proportion measure
Measure Type Outcome
Stratification

None

Risk Adjustment

None

Rationale

HIV is a communicable infection that leads to a progressive disease with a long asymptomatic period. Approximately 40,000 persons in the United States are newly infected with HIV each year (Centers for Disease Control and Prevention, 2021, p. 51). Without treatment, most persons develop...

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Clinical Recommendation Statement

Adult guidelines:

"The primary goal of antiretroviral therapy (ART) is to prevent HIV-associated morbidity and mortality. This goal is accomplished by using effective ART to achieve and maintain a plasma HIV-1 RNA (viral load) below the quantification limits of commercially available...

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Improvement Notation

Higher score equals better quality

Definition

Only patients diagnosed with HIV prior to or in the first 90 days of the measurement period are included in this measure to allow for sufficient time for patients to achieve viral suppression after their initial HIV diagnosis.

Only patients with an eligible encounter in the first 240 days...

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Guidance

HIV viral load data should be captured either as a numeric value or as a character/text value, depending on whether a given viral load result falls above or below the lab’s lower limit of detection. For viral loads at or above the lower limit of detection, the viral load should be...

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Initial Population

All patients, regardless of age, diagnosed with HIV prior to or during the first 90 days of the measurement period with at least one eligible encounter in the first 240 days of the measurement period

Denominator

Equals Initial Population

Denominator Exclusions

None

Numerator

Patients with a last HIV viral load test result of less than 200 copies/mL during the measurement period

Numerator Exclusions

None

Denominator Exceptions

None

Telehealth Eligible Yes
Next Version No Version Available
Previous Version

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

Updated copyright.

Copyright

Annual Update

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 'HIVViralSuppression ' to 'CMS314HIVViralSuppressionQDM' 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 Measure Primary CQL Library Name from 'HIVViralSuppression ' to 'CMS314HIVViralSuppressionQDM' for alignment with the CQL Style Guide.

Functions

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.'

Functions

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.

TRN

Measure Section

Source of Change

Replaced Value Set 'Face-to-Face Interaction' (2.16.840.1.113883.3.464.1003.101.12.1048) with 'Face to Face Interaction' (2.16.840.1.113762.1.4.1248.375).

Terminology

Annual Update

Value Set 'HIV' (2.16.840.1.113883.3.464.1003.120.12.1003): Deleted 6 ICD10CM codes (O98.711, O98.712, O98.713, O98.719, O98.72 O98.73) based on review by technical experts, SMEs and/or public feedback.

Terminology

Annual Update

Replaced Value Set 'HIV Viral Load' (2.16.840.1.113883.3.464.1003.120.12.1002) with 'HIV Viral Load Tests' (2.16.840.1.113762.1.4.1248.377).

Terminology

Annual Update

Value Set 'Office Visit' (2.16.840.1.113883.3.464.1003.101.12.1001): Added 1 SNOMEDCT code (185349003) based on review by technical experts, SMEs and/or public feedback.

Terminology

Annual Update

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

Value Set 'Telephone Visits' (2.16.840.1.113883.3.464.1003.101.12.1080): Added 8 CPT codes (98009, 98013, 98010, 98011, 98014, 98008, 98015, 98012) based on review by technical experts, SMEs and/or public feedback.

Terminology

Annual Update

Last Updated: May 07, 2025