| Measure Information | 2021 Performance Period |
|---|---|
| CMS Measure ID | CMS50v9 |
| NQF Number | Not Applicable |
| Measure Description |
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred |
| Initial Population | Number of patients, regardless of age, who were referred by one provider to another provider, and who had a visit during the measurement period |
| Denominator Statement |
Equals Initial Population |
| Denominator Exclusions |
None |
| Numerator Statement |
Number of patients with a referral, for which the referring provider received a report from the provider to whom the patient was referred |
| Numerator Exclusions |
Not Applicable |
| Denominator Exceptions |
None |
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) |
| Domain | Communication and Care Coordination |
| Measure Scoring | Proportion measure |
| Measure Type | Process measure |
| Improvement Notation |
A higher score indicates better quality |
| Guidance |
The provider who refers the patient to another provider is the provider who should be held accountable for the performance of this measure. The provider to whom the patient was referred should be the same provider that sends the report. If there are multiple referrals for a patient during the measurement period, use the first referral. The consultant report that will fulfill the referral should be completed after the referral and should be related to the referral for which it is attributed. If there are multiple consultant reports received by the referring provider which pertain to a particular referral, use the first consultant report to satisfy the measure. Eligible professionals or eligible clinicians reporting on this measure should note that all data for the reporting year is to be submitted by the deadline established by CMS. Therefore, eligible professionals or eligible clinicians who refer patients towards the end of the reporting period (i.e., November - December), should request that providers to whom they referred their patients share their consult reports as soon as possible in order for those patients to be counted in the measure numerator during the measurement period. When providers to whom patients are referred communicate the consult report as soon as possible with the referring providers, it ensures that the communication loop is closed in a timely manner and that the data are included in the submission to CMS. 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. |
| MIPS Quality ID | 374 |
| Meaningful Measure | Transfer of Health Information and Interoperability |
| Telehealth Eligible | Yes |
| Next Version | |
| Previous Version |
Data Element Repository
Header
-
Updated eCQM Version Number.
Measure Section: eCQM Version Number
Source of Change: Standards Update
-
Updated the measure developer field.
Measure Section: Measure Developer
Source of Change: Measure Lead
-
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
-
Updated disclaimer.
Measure Section: Disclaimer
Source of Change: Standards Update
-
Updated existing references to align with American Psychological Association (APA) formatting.
Measure Section: Reference
Source of Change: Measure Lead
-
Updated abbreviation in the definition field.
Measure Section: Definition
Source of Change: Measure Lead
-
Added text to identify the Quality Data Model (QDM) version used in the measure specification.
Measure Section: Guidance
Source of Change: Standards Update
-
Added text to indicate whether the measure is patient-based or episode-based.
Measure Section: Guidance
Source of Change: Standards Update
Logic
-
Added alternate datatype option for identifying the first referral based upon feedback.
Measure Section: Definitions
Source of Change: ONC Project Tracking System (Jira): CQM-3561
-
QDM v5.5 standards update: Added 'relevantDatetime' attribute to QDM datatypes. 'RelevantDatetime' indicates when the action occurred whereas 'authorDatetime' indicates when the action was recorded.
Measure Section: Multiple Sections
Source of Change: Standards Update
-
QDM v5.5 standards update: Updated 'Communication, Performed' timing to use new 'sent dateTime' and 'received dateTime' attributes to better align with measure intent.
Measure Section: Multiple Sections
Source of Change: Standards Update
-
Revised Clinical Quality Language (CQL) definition construction to reduce the overall complexity of the measure logic without changing the intent and/or application of data element. These revisions were intended to make the definition logic less complex, easier to understand, and more meaningful.
Measure Section: Multiple Sections
Source of Change: Measure Lead
-
Updated CQL expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).
Measure Section: Multiple Sections
Source of Change: Standards Update
-
Updated CQL definition names and aliases used to more closely align with clinical concept intent or create consistency of naming across measures.
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.
-
Value set Referral (2.16.840.1.113883.3.464.1003.101.12.1046): Deleted 1 SNOMED CT code (306274009) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
-
Value set Consultant Report (2.16.840.1.113883.3.464.1003.121.12.1006): Deleted 1 LOINC code (60570-9).
Measure Section: Terminology
Source of Change: Annual Update