Kidney Health Evaluation

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Measure Information	2023 Performance Period	2024 Performance Period	2025 Performance Period	2026 Performance Period
Title	Kidney Health Evaluation	Kidney Health Evaluation	Kidney Health Evaluation	Kidney Health Evaluation
CMS eCQM ID	CMS951v1	CMS951v2	CMS951v3	CMS951v4
CBE ID*	Not Applicable	Not Applicable	Not Applicable	Not Applicable
MIPS Quality ID	488	488	488	488
Measure Steward	National Kidney Foundation	National Kidney Foundation	National Kidney Foundation	National Kidney Foundation
Description	Percentage of patients aged 18-75 years with a diagnosis of diabetes who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period	Percentage of patients aged 18-75 years with a diagnosis of diabetes who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period	Percentage of patients aged 18-85 years with a diagnosis of diabetes who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period	Percentage of patients aged 18-85 years with a diagnosis of diabetes who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period
Measure Scoring	Proportion measure	Proportion measure	Proportion measure	Proportion measure
Measure Type	Process	Process	Process	Process
Stratification	*See CMS951v1.html	None	None	None
Risk Adjustment	*See CMS951v1.html	None	None	None
Rationale	*See CMS951v1.html	Chronic Kidney Disease (CKD) is a major driver of morbidity, mortality and high healthcare costs in the United States. Currently, 37 million American adults have CKD and millions of others are at increased risk (National Kidney Foundation [NKF], 2019), with an estimated population... prevalence growing to nearly 17% among Americans aged 30 years and older by the year 2030 (Saran et al., 2019; Hoerger et al., 2015). Total Medicare spending in 2016 on both CKD and End-Stage Renal Disease (ESRD) was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran et al., 2019; Nichols et al., 2020). In the US from 2002-2016, the burden of CKD, defined as years of life lost, years living with disability, disability-adjusted life years, and deaths, outpaced changes in the burden of disease for other conditions (Bowe et al., 2018). Patients with CKD are readmitted to the hospital more frequently than those without diagnosed CKD (Saran et al., 2019). CKD is the 9th leading cause of death in the US and is the fastest growing non-communicable disease in terms of in burden largely due to death (Hoerger et al., 2015; Bowe et al., 2018). This public health issue is driven largely by the impact of diabetes—the most common comorbid risk factor for CKD (Saran et al., 2019; Bowe et al., 2018). The intent of this process measure is to improve rates of guideline-concordant kidney health evaluation in patients with diabetes to more consistently identify and potentially treat or delay progression of CKD in this high-risk population. Annual kidney health evaluation in patients with diabetes to determine risk of CKD using eGFR and uACR is recommended by clinical practice guidelines (ADA, 2022; NKF, 2007; NKF, 2012) and has been a focus of various local and national health care quality improvement initiatives, including Healthy People 2020 (United States Renal Data System, 2018). However, performance of these tests in patients with diabetes remains low, with rates that vary across Medicare (41.8%) and private insurers (49.0%) (Saran et al., 2019; Alfego et al., 2021; Stempneiwicz et al., 2021). Low rates of detection of CKD in a population of patients with diabetes have been demonstrated to be associated with low patient awareness of their own kidney health status (Szczech et al., 2014). Indeed, 90% of individuals with CKD are unaware of their condition due to under-recognition and under-diagnosis (Saran et al., 2019; Centers for Disease Control and Prevention, 2019). Currently, an individual’s lifetime probability of developing CKD is relatively high, reaching 54% for someone currently aged 30-49 years (Hoerger et al., 2015). Regular kidney health evaluations, utilizing both eGFR and uACR, provide an opportunity to improve identification and potential reversal of worsening kidney function, particularly in high risk populations, such as those with diabetes. Show more > Chronic Kidney Disease (CKD) is a major driver of morbidity, mortality and high healthcare costs in the United States. Currently, 37 million American adults have CKD and millions of others are at increased risk (National Kidney Foundation [NKF], 2019), with an estimated population prevalence growing to nearly 17% among Americans aged 30 years and older by the year 2030 (Saran et al., 2019; Hoerger et al., 2015). Total Medicare spending in 2016 on both CKD and End-Stage Renal Disease (ESRD) was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran et al., 2019; Nichols et al., 2020). In the US from 2002-2016, the burden of CKD, defined as years of life lost, years living with disability, disability-adjusted life years, and deaths, outpaced changes in the burden of disease for other conditions (Bowe et al., 2018). Patients with CKD are readmitted to the hospital more frequently than those without diagnosed CKD (Saran et al., 2019). CKD is the 9th leading cause of death in the US and is the fastest growing non-communicable disease in terms of in burden largely due to death (Hoerger et al., 2015; Bowe et al., 2018). This public health issue is driven largely by the impact of diabetes—the most common comorbid risk factor for CKD (Saran et al., 2019; Bowe et al., 2018). The intent of this process measure is to improve rates of guideline-concordant kidney health evaluation in patients with diabetes to more consistently identify and potentially treat or delay progression of CKD in this high-risk population. Annual kidney health evaluation in patients with diabetes to determine risk of CKD using eGFR and uACR is recommended by clinical practice guidelines (ADA, 2022; NKF, 2007; NKF, 2012) and has been a focus of various local and national health care quality improvement initiatives, including Healthy People 2020 (United States Renal Data System, 2018). However, performance of these tests in patients with diabetes remains low, with rates that vary across Medicare (41.8%) and private insurers (49.0%) (Saran et al., 2019; Alfego et al., 2021; Stempneiwicz et al., 2021). Low rates of detection of CKD in a population of patients with diabetes have been demonstrated to be associated with low patient awareness of their own kidney health status (Szczech et al., 2014). Indeed, 90% of individuals with CKD are unaware of their condition due to under-recognition and under-diagnosis (Saran et al., 2019; Centers for Disease Control and Prevention, 2019). Currently, an individual’s lifetime probability of developing CKD is relatively high, reaching 54% for someone currently aged 30-49 years (Hoerger et al., 2015). Regular kidney health evaluations, utilizing both eGFR and uACR, provide an opportunity to improve identification and potential reversal of worsening kidney function, particularly in high risk populations, such as those with diabetes. Show less	Chronic Kidney Disease (CKD) is a major driver of morbidity, mortality and high healthcare costs in the United States. Currently, 37 million American adults have CKD and millions of others are at increased risk (National Kidney Foundation [NKF], 2022), with an estimated population... prevalence growing to nearly 17% among Americans aged 30 years and older by the year 2030 (Saran et al., 2019; Hoerger et al., 2015). Total Medicare spending in 2016 on both CKD and End-Stage Renal Disease (ESRD) was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran et al., 2019; Nichols et al., 2020). In the US from 2002-2016, the burden of CKD, defined as years of life lost, years living with disability, disability-adjusted life years, and deaths, outpaced changes in the burden of disease for other conditions (Bowe et al., 2018). Patients with CKD are readmitted to the hospital more frequently than those without diagnosed CKD (Saran et al., 2019). CKD is the 9th leading cause of death in the US and is the fastest growing non-communicable disease in terms of in burden largely due to death (Hoerger et al., 2015; Bowe et al., 2018). This public health issue is driven largely by the impact of diabetes—the most common comorbid risk factor for CKD (Saran et al., 2019; Bowe et al., 2018). The intent of this process measure is to improve rates of guideline-concordant kidney health evaluation in patients with diabetes to more consistently identify and potentially treat or delay progression of CKD in this high-risk population. Annual kidney health evaluation in patients with diabetes to determine risk of CKD using eGFR and uACR is recommended by clinical practice guidelines (American Diabetes Association, 2022; de Boer, 2022; NKF, 2007; NKF, 2012) and has been a focus of various local and national health care quality improvement initiatives, including Healthy People 2030 (Healthy People 2030, 2023). However, performance of these tests in patients with diabetes remains low, with rates that vary across Medicare (41.8%) and private insurers (49.0%) (Saran et al., 2019; Alfego et al., 2021; Stempneiwicz et al., 2021). Low rates of detection of CKD in a population of patients with diabetes have been demonstrated to be associated with low patient awareness of their own kidney health status (Szczech et al., 2014). Indeed, 90% of individuals with CKD are unaware of their condition due to under-recognition and under-diagnosis (Saran, et al., 2019; Centers for Disease Control and Prevention, 2023). Currently, an individual’s lifetime probability of developing CKD is relatively high, reaching 54% for someone currently aged 30-49 years (Hoerger et al., 2015). Regular kidney health evaluations, utilizing both eGFR and uACR, provide an opportunity to improve identification and potential reversal of worsening kidney function, particularly in high risk populations, such as those with diabetes. Show more > Chronic Kidney Disease (CKD) is a major driver of morbidity, mortality and high healthcare costs in the United States. Currently, 37 million American adults have CKD and millions of others are at increased risk (National Kidney Foundation [NKF], 2022), with an estimated population prevalence growing to nearly 17% among Americans aged 30 years and older by the year 2030 (Saran et al., 2019; Hoerger et al., 2015). Total Medicare spending in 2016 on both CKD and End-Stage Renal Disease (ESRD) was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran et al., 2019; Nichols et al., 2020). In the US from 2002-2016, the burden of CKD, defined as years of life lost, years living with disability, disability-adjusted life years, and deaths, outpaced changes in the burden of disease for other conditions (Bowe et al., 2018). Patients with CKD are readmitted to the hospital more frequently than those without diagnosed CKD (Saran et al., 2019). CKD is the 9th leading cause of death in the US and is the fastest growing non-communicable disease in terms of in burden largely due to death (Hoerger et al., 2015; Bowe et al., 2018). This public health issue is driven largely by the impact of diabetes—the most common comorbid risk factor for CKD (Saran et al., 2019; Bowe et al., 2018). The intent of this process measure is to improve rates of guideline-concordant kidney health evaluation in patients with diabetes to more consistently identify and potentially treat or delay progression of CKD in this high-risk population. Annual kidney health evaluation in patients with diabetes to determine risk of CKD using eGFR and uACR is recommended by clinical practice guidelines (American Diabetes Association, 2022; de Boer, 2022; NKF, 2007; NKF, 2012) and has been a focus of various local and national health care quality improvement initiatives, including Healthy People 2030 (Healthy People 2030, 2023). However, performance of these tests in patients with diabetes remains low, with rates that vary across Medicare (41.8%) and private insurers (49.0%) (Saran et al., 2019; Alfego et al., 2021; Stempneiwicz et al., 2021). Low rates of detection of CKD in a population of patients with diabetes have been demonstrated to be associated with low patient awareness of their own kidney health status (Szczech et al., 2014). Indeed, 90% of individuals with CKD are unaware of their condition due to under-recognition and under-diagnosis (Saran, et al., 2019; Centers for Disease Control and Prevention, 2023). Currently, an individual’s lifetime probability of developing CKD is relatively high, reaching 54% for someone currently aged 30-49 years (Hoerger et al., 2015). Regular kidney health evaluations, utilizing both eGFR and uACR, provide an opportunity to improve identification and potential reversal of worsening kidney function, particularly in high risk populations, such as those with diabetes. Show less	Chronic Kidney Disease (CKD) is a major driver of morbidity, mortality and high healthcare costs in the United States. Currently, 37 million American adults have CKD and millions of others are at increased risk (National Kidney Foundation [NKF], 2022), with an estimated population... prevalence growing to nearly 17% among Americans aged 30 years and older by the year 2030 (Saran et al., 2019; Hoerger et al., 2015). Total Medicare spending in 2016 on both CKD and End-Stage Renal Disease (ESRD) was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran et al., 2019; Nichols et al., 2020). In the US from 2002-2016, the burden of CKD, defined as years of life lost, years living with disability, disability-adjusted life years, and deaths, outpaced changes in the burden of disease for other conditions (Bowe et al., 2018). Patients with CKD are readmitted to the hospital more frequently than those without diagnosed CKD (Saran et al., 2019). CKD is the 9th leading cause of death in the US and is the fastest growing non-communicable disease in terms of in burden largely due to death (Hoerger et al., 2015; Bowe et al., 2018). This public health issue is driven largely by the impact of diabetes—the most common comorbid risk factor for CKD (Saran et al., 2019; Bowe et al., 2018). The intent of this process measure is to improve rates of guideline-concordant kidney health evaluation in patients with diabetes to more consistently identify and potentially treat or delay progression of CKD in this high-risk population. Annual kidney health evaluation in patients with diabetes to determine risk of CKD using eGFR and uACR is recommended by clinical practice guidelines (American Diabetes Association, 2022; de Boer, 2022; NKF, 2007; NKF, 2012) and has been a focus of various local and national health care quality improvement initiatives, including Healthy People 2030 (Healthy People 2030, 2023). However, performance of these tests in patients with diabetes remains low, with rates that vary across Medicare (41.8%) and private insurers (49.0%) (Saran et al., 2019; Alfego et al., 2021; Stempneiwicz et al., 2021). Low rates of detection of CKD in a population of patients with diabetes have been demonstrated to be associated with low patient awareness of their own kidney health status (Szczech et al., 2014). Indeed, 90% of individuals with CKD are unaware of their condition due to under-recognition and under-diagnosis (Saran, et al., 2019; Centers for Disease Control and Prevention, 2023). Currently, an individual’s lifetime probability of developing CKD is relatively high, reaching 54% for someone currently aged 30-49 years (Hoerger et al., 2015). Regular kidney health evaluations, utilizing both eGFR and uACR, provide an opportunity to improve identification and potential reversal of worsening kidney function, particularly in high risk populations, such as those with diabetes. Show more > Chronic Kidney Disease (CKD) is a major driver of morbidity, mortality and high healthcare costs in the United States. Currently, 37 million American adults have CKD and millions of others are at increased risk (National Kidney Foundation [NKF], 2022), with an estimated population prevalence growing to nearly 17% among Americans aged 30 years and older by the year 2030 (Saran et al., 2019; Hoerger et al., 2015). Total Medicare spending in 2016 on both CKD and End-Stage Renal Disease (ESRD) was over $114 billion, comprising 23% of total Medicare fee-for-service spending overall with costs increasing exponentially with advancing CKD (Saran et al., 2019; Nichols et al., 2020). In the US from 2002-2016, the burden of CKD, defined as years of life lost, years living with disability, disability-adjusted life years, and deaths, outpaced changes in the burden of disease for other conditions (Bowe et al., 2018). Patients with CKD are readmitted to the hospital more frequently than those without diagnosed CKD (Saran et al., 2019). CKD is the 9th leading cause of death in the US and is the fastest growing non-communicable disease in terms of in burden largely due to death (Hoerger et al., 2015; Bowe et al., 2018). This public health issue is driven largely by the impact of diabetes—the most common comorbid risk factor for CKD (Saran et al., 2019; Bowe et al., 2018). The intent of this process measure is to improve rates of guideline-concordant kidney health evaluation in patients with diabetes to more consistently identify and potentially treat or delay progression of CKD in this high-risk population. Annual kidney health evaluation in patients with diabetes to determine risk of CKD using eGFR and uACR is recommended by clinical practice guidelines (American Diabetes Association, 2022; de Boer, 2022; NKF, 2007; NKF, 2012) and has been a focus of various local and national health care quality improvement initiatives, including Healthy People 2030 (Healthy People 2030, 2023). However, performance of these tests in patients with diabetes remains low, with rates that vary across Medicare (41.8%) and private insurers (49.0%) (Saran et al., 2019; Alfego et al., 2021; Stempneiwicz et al., 2021). Low rates of detection of CKD in a population of patients with diabetes have been demonstrated to be associated with low patient awareness of their own kidney health status (Szczech et al., 2014). Indeed, 90% of individuals with CKD are unaware of their condition due to under-recognition and under-diagnosis (Saran, et al., 2019; Centers for Disease Control and Prevention, 2023). Currently, an individual’s lifetime probability of developing CKD is relatively high, reaching 54% for someone currently aged 30-49 years (Hoerger et al., 2015). Regular kidney health evaluations, utilizing both eGFR and uACR, provide an opportunity to improve identification and potential reversal of worsening kidney function, particularly in high risk populations, such as those with diabetes. Show less
Clinical Recommendation Statement	*See CMS951v1.html	The following evidence statements are quoted verbatim from the referenced clinical guidelines and other sources, where applicable: At least once a year, assess urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate in patients with type 1... diabetes with duration of >= 5 years, in all patients with type 2 diabetes, and in all patients with comorbid hypertension. B (American Diabetes Association Professional Practice Committee, 2019) Patients with diabetes should be screened annually for Diabetic Kidney Disease (DKD). Initial screening should commence: - 5 years after the diagnosis of type 1 diabetes; (A) or - From diagnosis of type 2 diabetes. (B) Screening should include: - Measurements of urinary albumin-creatinine ratio (ACR) in a spot urine sample; (B) - Measurement of serum creatinine and estimation of GFR. (B) (NKF, 2007; NKF, 2012) Show more > The following evidence statements are quoted verbatim from the referenced clinical guidelines and other sources, where applicable: At least once a year, assess urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate in patients with type 1 diabetes with duration of >= 5 years, in all patients with type 2 diabetes, and in all patients with comorbid hypertension. B (American Diabetes Association Professional Practice Committee, 2019) Patients with diabetes should be screened annually for Diabetic Kidney Disease (DKD). Initial screening should commence: - 5 years after the diagnosis of type 1 diabetes; (A) or - From diagnosis of type 2 diabetes. (B) Screening should include: - Measurements of urinary albumin-creatinine ratio (ACR) in a spot urine sample; (B) - Measurement of serum creatinine and estimation of GFR. (B) (NKF, 2007; NKF, 2012) Show less	The following evidence statements are quoted verbatim from the referenced clinical guidelines and other sources, where applicable: At least annually, urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate should be assessed in people with... type 1 diabetes with duration of ≥5 years and in all people with type 2 diabetes regardless of treatment. B (American Diabetes Association Professional Practice Committee, 2023) Patients with diabetes should be screened annually for Diabetic Kidney Disease (DKD). Initial screening should commence: - 5 years after the diagnosis of type 1 diabetes; (A) or - From diagnosis of type 2 diabetes. (B) Screening should include: - Measurements of urinary albumin-creatinine ratio (ACR) in a spot urine sample; (B) - Measurement of serum creatinine and estimation of GFR. (B) (NKF, 2007; NKF, 2012) Show more > The following evidence statements are quoted verbatim from the referenced clinical guidelines and other sources, where applicable: At least annually, urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate should be assessed in people with type 1 diabetes with duration of ≥5 years and in all people with type 2 diabetes regardless of treatment. B (American Diabetes Association Professional Practice Committee, 2023) Patients with diabetes should be screened annually for Diabetic Kidney Disease (DKD). Initial screening should commence: - 5 years after the diagnosis of type 1 diabetes; (A) or - From diagnosis of type 2 diabetes. (B) Screening should include: - Measurements of urinary albumin-creatinine ratio (ACR) in a spot urine sample; (B) - Measurement of serum creatinine and estimation of GFR. (B) (NKF, 2007; NKF, 2012) Show less	The following evidence statements are quoted verbatim from the referenced clinical guidelines and other sources, where applicable: At least annually, urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate should be assessed in people with... type 1 diabetes with duration of ≥5 years and in all people with type 2 diabetes regardless of treatment. B (American Diabetes Association Professional Practice Committee, 2023) Patients with diabetes should be screened annually for Diabetic Kidney Disease (DKD). Initial screening should commence: - 5 years after the diagnosis of type 1 diabetes; (A) or - From diagnosis of type 2 diabetes. (B) Screening should include: - Measurements of urinary albumin-creatinine ratio (ACR) in a spot urine sample; (B) - Measurement of serum creatinine and estimation of GFR. (B) (NKF, 2007; NKF, 2012) Show more > The following evidence statements are quoted verbatim from the referenced clinical guidelines and other sources, where applicable: At least annually, urinary albumin (e.g., spot urinary albumin-to-creatinine ratio) and estimated glomerular filtration rate should be assessed in people with type 1 diabetes with duration of ≥5 years and in all people with type 2 diabetes regardless of treatment. B (American Diabetes Association Professional Practice Committee, 2023) Patients with diabetes should be screened annually for Diabetic Kidney Disease (DKD). Initial screening should commence: - 5 years after the diagnosis of type 1 diabetes; (A) or - From diagnosis of type 2 diabetes. (B) Screening should include: - Measurements of urinary albumin-creatinine ratio (ACR) in a spot urine sample; (B) - Measurement of serum creatinine and estimation of GFR. (B) (NKF, 2007; NKF, 2012) Show less
Improvement Notation	Higher score indicates better quality	Higher score indicates better quality	Higher score indicates better quality	Higher score indicates better quality
Definition	*See CMS951v1.html	None	None	None
Guidance	This measure assesses performance of a comprehensive kidney evaluation in adults aged 18-75. This measure does not preclude or discourage the use of regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 75 years of age). 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 > This measure assesses performance of a comprehensive kidney evaluation in adults aged 18-75. This measure does not preclude or discourage the use of regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 75 years of age). 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	This measure assesses performance of a comprehensive kidney evaluation in adults aged 18-75. This measure does not preclude or discourage the use of regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 75 years of age). 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 > This measure assesses performance of a comprehensive kidney evaluation in adults aged 18-75. This measure does not preclude or discourage the use of regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 75 years of age). 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	This measure assesses performance of a comprehensive kidney evaluation in adults aged 18-85. This measure does not preclude or discourage the use of regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 85 years of age). 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 > This measure assesses performance of a comprehensive kidney evaluation in adults aged 18-85. This measure does not preclude or discourage the use of regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 85 years of age). 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	This measure assesses the performance of a comprehensive kidney evaluation in adults aged 18-85. This measure does not preclude or discourage regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 85 years of age). The Urine... Albumin-Creatinine Ratio (uACR) requirement can be met with a documented Urine Albumin and Urine Creatine conducted on the same urine sample AND reported less than or equal to four days apart. A calculation of uACR is not required to meet this measure, but it is intended to for the uACR to be calculated for the purposes of kidney health evaluation. If the Urine Albumin and Urine Creatine tests have different units of measure, they should be converted to the same unit of measure for the purposes of calculating uACR. The Urine Albumin Creatinine Ratio Test requirement can be met if the lab result is received as a quantitative value or as an undetectable result. Undetectable results can be coded using values in the "Undetectable Lab Result Value" value set. 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 > This measure assesses the performance of a comprehensive kidney evaluation in adults aged 18-85. This measure does not preclude or discourage regular laboratory testing for CKD in patients outside of the age range (patients under 18 years and those over 85 years of age). The Urine Albumin-Creatinine Ratio (uACR) requirement can be met with a documented Urine Albumin and Urine Creatine conducted on the same urine sample AND reported less than or equal to four days apart. A calculation of uACR is not required to meet this measure, but it is intended to for the uACR to be calculated for the purposes of kidney health evaluation. If the Urine Albumin and Urine Creatine tests have different units of measure, they should be converted to the same unit of measure for the purposes of calculating uACR. The Urine Albumin Creatinine Ratio Test requirement can be met if the lab result is received as a quantitative value or as an undetectable result. Undetectable results can be coded using values in the "Undetectable Lab Result Value" value set. 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	All patients aged 18-75 years with a diagnosis of diabetes at the start of the measurement period with a visit during the measurement period	All patients aged 18-75 years with a diagnosis of diabetes at the start of the measurement period with a visit during the measurement period	All patients aged 18-85 years with a diagnosis of diabetes at the start of the measurement period with a visit during the measurement period	All patients aged 18-85 years with a diagnosis of diabetes at the start of the measurement period with a visit during the measurement period
Denominator	Equals Initial Population	Equals Initial Population	Equals Initial Population	Equals Initial Population
Denominator Exclusions	Patients with a diagnosis of End Stage Renal Disease (ESRD); Patients with a diagnosis of Chronic Kidney Disease (CKD) Stage 5; Patients who have an order for or are receiving hospice or palliative care	Patients with a diagnosis of ESRD; Patients with a diagnosis of CKD Stage 5; Patients who have an order for or are receiving hospice or palliative care	Patients with a diagnosis of ESRD active during the measurement period; Patients with a diagnosis of CKD Stage 5 active during the measurement period; Patients who have an order for or are receiving hospice or palliative care	Patients with a diagnosis of ESRD active during the measurement period; Patients with a diagnosis of CKD Stage 5 active during the measurement period; Patients who have an order for or are receiving hospice or palliative care
Numerator	Patients who received a kidney health evaluation defined by an Estimated Glomerular Filtration Rate (eGFR) AND Urine Albumin-Creatinine Ratio (uACR) within the measurement period	Patients who received a kidney health evaluation defined by an eGFR AND uACR within the measurement period	Patients who received a kidney health evaluation defined by an eGFR AND uACR within the measurement period	Patients who received a kidney health evaluation during the measurement period. Kidney health evaluation is defined by an eGFR AND uACR within the measurement period OR an eGFR and a Urine Albumin and Urine Creatine result documented less than or equal to four days apart ... Show more > Patients who received a kidney health evaluation during the measurement period. Kidney health evaluation is defined by an eGFR AND uACR within the measurement period OR an eGFR and a Urine Albumin and Urine Creatine result documented less than or equal to four days apart Show less
Numerator Exclusions	Not Applicable	Not Applicable	Not Applicable	None
Denominator Exceptions	None	None	None	None
Telehealth Eligible	Yes	Yes	Yes	Yes
Next Version	No Version Available	CMS951v3	CMS951v4	No Version Available
Previous Version	No Version Available	CMS951v1	CMS951v2	CMS951v3

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Additional Resources for CMS951v4

CMS951-v4.0.000-TRN.xlsx

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
Removed 'PCPI(R) Foundation (PCPI[R])' as a Measure Developer to reflect active Measure Developers.	Measure Developer	Annual Update
Updated copyright.	Copyright	Annual Update
Updated disclaimer.	Disclaimer	Annual Update
Updated references and measure header to reflect current evidence and new or updated literature.	Multiple Sections	Measure Lead
Revised the guidance section to add that a Urine Albumin-Creatinine Ratio (uACR) requirement can be met with a documented Urine Albumin and Urine Creatine conducted on the same urine sample AND reported less than or equal to four days apart. A calculation of uACR is not required to meet this measure, but it is intended to for the uACR to be calculated for the purposes of kidney health evaluation. If the Urine Albumin and Urine Creatine tests have different units of measure, they should be converted to the same unit of measure for the purposes of calculating uACR.	Guidance	Measure Lead
Revised the guidance section to indicate that undetectable Urine Albumin Creatinine Ratio tests with undetectable results can be coded using values in the "Undetectable Lab Result Value" value set.	Guidance	Measure Lead
Revised numerator to expand allowable kidney health evaluation criteria, which includes an eGFR AND uACR within the measurement period OR an eGFR and a Urine Albumin and Urine Creatine result documented less than or equal to four days apart.	Numerator	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 'KidneyHealthEvaluation' to 'CMS951KidneyHealthEvaluationQDM' 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 PalliativeCareQDM library to 5.0.000.	Definitions	Annual Update
Updated the timing comparison precision in the definitions by adding 'day of' operator to align with the measure intent and address time zone differences.	Definitions	Measure Lead
Added individual Urine Albumin and Urine Creatinine testing with results less than or equal to 4 days apart as a proxy to uACR. Expressions used in this solution: Added individual Urine Albumin and Urine Creatinine testing with results less than or equal to 4 days apart as a proxy to uACR.	Definitions	ONC Project Tracking System (JIRA): CQM-6907
Added a codified result solution to the uACR logic expression so that uACR tests with undetectable results can be captured through the use of SNOMEDCT values included in the value set.	Definitions	ONC Project Tracking System (JIRA): CQM-6907
Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.	Definitions	Annual Update
Updated Measure Primary CQL Library Name from 'KidneyHealthEvaluation' to 'CMS951KidneyHealthEvaluationQDM' 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
Updated the version number of the HospiceQDM library to 7.0.000.	Functions	Annual Update
Updated the version number of the PalliativeCareQDM library to 5.0.000.	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
Value Set 'Diabetes' (2.16.840.1.113883.3.464.1003.103.12.1001): Added 1 ICD10CM extensional value set (2.16.840.1.113883.3.464.1003.1272) based on review by technical experts, SMEs and/or public feedback. Deleted 3 ICD10 extensional value sets (2.16.840.1.113883.3.464.1003.103.11.1032, 2.16.840.1.113883.3.464.1003.103.11.1026, 2.16.840.1.113883.3.464.1003.103.11.1031) based on review by technical experts, SMEs and/or public feedback. Added 1 SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.1273) based on review by technical experts, SMEs and/or public feedback. Deleted 2 SNOMEDCT extensional value sets (2.16.840.1.113883.3.464.1003.103.11.1027, 2.16.840.1.113883.3.464.1003.103.11.1030) based on review by technical experts, SMEs and/or public feedback.	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 'Palliative Care Encounter' (2.16.840.1.113883.3.464.1003.101.12.1090): Deleted 1 HCPCS code (M1017) based on review by technical experts, SMEs and/or public feedback.	Terminology	Annual 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
Value Set 'Undetectable Lab Result Value' (2.16.840.1.113762.1.4.1248.272) containing 10 SNOMEDCT codes (371928007, 272519000, 260415000, 260389003, 281297005, 131194007, 260988000, 2667000, 47492008, 444991000124106)added to measure based on public comment or implementer feedback.	Terminology	ONC Project Tracking System (JIRA): CQM-6907
Value Set 'Urine Albumin' (2.16.840.1.113762.1.4.1178.88) containing 24 LOINC codes (43605-5, 77940-5, 43606-3, 43607-1, 53532-8, 6942-7, 49002-9, 49023-5, 14957-5, 50949-7, 6941-9, 30003-8, 63474-1, 50209-6, 53530-2, 51190-7, 56553-1, 14956-7, 1755-8, 1754-1, 21059-1, 58448-2, 53531-0, 11218-5) added to measure based on guidance update to allow a Urine Albumin and Urine Creatine result documented less than or equal to four days apart meet numerator criteria.	Terminology	ONC Project Tracking System (JIRA): CQM-6907
Value Set 'Urine Creatinine' (2.16.840.1.113762.1.4.1178.87) containing 11 LOINC codes (58951-5, 2161-8, 25886-3, 2150-1, 2149-3, 20624-3, 30004-6, 14683-7, 55593-8, 35674-1, 57346-9) added to measure based on guidance update to allow a Urine Albumin and Urine Creatine result documented less than or equal to four days apart meet numerator criteria.	Terminology	ONC Project Tracking System (JIRA): CQM-6907

Compare Versions of: "Kidney Health Evaluation"

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