Closing the Referral Loop: Receipt of Specialist Report

Last updated: October 25, 2017

CMS Measure ID: CMS50v6
Version: 6
NQF Number: None
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 Patient 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 and Medicaid Services (CMS)
Domain: Communication and Care Coordination
Previous Version: Closing the Referral Loop: Receipt of Specialist Report
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 see patients towards the end of the reporting period (ie, December in particular), should communicate the consultant report as soon as possible in order for those patients to be counted in the measure numerator. Communicating the report as soon as possible will ensure the data is included in the submission to CMS.

Specifications

Release Notes

Header

  • ​Incremented eMeasure Version number.

    Measure Section: eMeasure Version number

    Source of Change: Measure Lead

  • ​Updated Copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated References.

    Measure Section: Reference

    Source of Change: Measure Lead

  • ​Updated Guidance.

    Measure Section: Guidance

    Source of Change: JIRA (CQM-2313)

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): Added 30 SNOMEDCT codes and deleted 4 SNOMEDCT codes (306160005, 306161009, 306162002, 390807002).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

External Resources