Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

Last updated: May 3, 2018

CMS Measure ID: CMS22v4
Version: 4
NQF Number: None
Measure Description:

Percentage of patients aged 18 years and older seen during the reporting period who were screened for high blood pressure AND a recommended follow-up plan is documented based on the current blood pressure (BP) reading as indicated

Initial Patient Population:

All patients aged 18 years and older before the start of the measurement period with at least one eligible encounter during the measurement period

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patient has an active diagnosis of hypertension

Numerator Statement:

Patients who were screened for high blood pressure AND have a recommended follow-up plan documented, as indicated if the blood pressure is pre-hypertensive or hypertensive

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

Patient Reason(s):

Patient refuses to participate (either BP measurement or follow-up)


Medical Reason(s):

Patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status. This may include but is not limited to severely elevated BP when immediate medical treatment is indicated.

Measure Steward: Centers for Medicare and Medicaid Services
Domain: Community/Population Health
Next Version:
Previous Version:
Measure Score: Proportion
Improvement Notation:

Higher score indicates better quality.


Both the systolic and diastolic blood pressure measurements are required for inclusion. If there are multiple blood pressures on the same date of service, use the most recent as the representative blood pressure.

Eligible professionals who report the measure must perform the blood pressure screening at the time of a qualifying visit by an eligible professional and may not obtain measurements from external sources.

The intent of this measure is to screen patients for high blood pressure and provide recommended follow-up as indicated. The documented follow-up plan must be related to the current BP reading as indicated, example: Patient referred to primary care provider for BP management.


Release Notes


  • Copyright updated.
  • Definition updated.
  • Denominator Exceptions updated.
  • Disclaimer updated.
  • eMeasure version number incremented.
  • Guidance updated.
  • Initial Population updated.
  • Reference updated.


  • Added Denominator Exception logic to allow for patient refusal of follow-up data elements.
  • Changed data type of 'result' or 'finding' to 'performed'.
  • Changed the timing logic to use the new temporal operator 'starts after or concurrent with start of' to improve timing precision.
  • Introduced function 'satisfies all' to specify that qualifying events must meet all conditions from a set of conditions or 'satisfies any' to specify that qualifying events must meet at least one condition from a set of conditions to streamline expression logic.
  • Introduced variable $HypertensionRecommendations to allow re-use of logical expressions and reduce redundancy/complexity.
  • Replaced 'ORs' with 'Union of' operator to provide a mechanism for specifying that qualifying event(s) must be a member of at least one of the data elements being unioned (if appropriate for measure intent).Introduced occurrencing on variables to enforce that the same instance of a clinical event is used throughout the measure when the logic within the variable does not limit the event to a single instance, e.g., FIRST or MOST RECENT.
  • Replaced 'Patient Characteristic Birthdate' with 'Age at' operator.
  • The top level logical operator for the Numerator Exclusions, Denominator Exclusions, Denominator Exceptions, and Measure Population Exclusions defaults to 'OR'.
  • Updated Numerator logic┬áto place focus on most recent encounter where a BP reading is documented (as opposed to most recent encounter). Also specifies most recent reading during encounter.

Value Sets

  • Added 6 CPT codes (99385, 99386, 99387, 99395, 99396, 99397) to BP Screening Denominator Encounter Codes Grouped New OID 2.16.840.1.113883.3.600.1920; Changed the name of BP Screening Denominator Encounter Codes Grouped New OID 2.16.840.1.113883.3.600.1920 to BP Screening Encounter Codes.
  • Replaced value set Medical reason (OID 2.16.840.1.113883.3.600.1521) with value set Medical or Other reason not done (OID 2.16.840.1.113883.3.600.1.1502).
  • Value set Anti-Hypertensive Pharmacologic Therapy (OID 2.16.840.1.113883.3.600.1476): Deleted 3 RXNORM codes (197562, 197563, 197564) and added 15 RXNORM codes (308614, 282486, 197417, 197418, 197419, 104222, 197977, 198110, 198111, 198112, 198312, 245284, 198313, 245283, 198319).
  • Value set BP Screening Encounter Codes Grouped (OID 2.16.840.1.113883.3.600.1920): Updated Value Set Name from BP Screening Denominator Encounter Codes Grouped New to BP Screening Encounter Codes Grouped and added 6 CPT codes (99385, 99386, 99387, 99395, 99396, 99397).
  • Value set Diagnosis of hypertension grouped (OID 2.16.840.1.113883.3.600.263) renamed 'Dianosis of hypertension'; Deleted 8 SNOMED codes (160273004, 26174007, 275944005, 276789009, 302192008, 390925005, 401118009, 412779008).

External Resources