Functional Status Assessment for Complex Chronic Conditions

Last updated: May 3, 2018

CMS Measure ID: CMS90v4
Version: 4
NQF Number: None
Measure Description:

Percentage of patients aged 65 years and older with heart failure who completed initial and follow-up patient-reported functional status assessments

Initial Patient Population:

Adults aged 65 years and older who had two outpatient encounters during the measurement year and an active diagnosis of heart failure.

Denominator Statement:

Equals Initial Patient Population

Denominator Exclusions:

Patients with severe cognitive impairment or patients with an active diagnosis of cancer

Numerator Statement:

Patients with patient reported functional status assessment results (e.g., VR-12; VR-36; MLHF-Q; KCCQ; PROMIS-10 Global Health, PROMIS-29) present in the EHR within two weeks before or during the initial encounter and the follow-up encounter during the measurement year.

Numerator Exclusions:

Not Applicable

Denominator Exceptions:


Measure Steward: Centers for Medicare and Medicaid Services
Domain: Person and Caregiver-Centered Experience Outcomes
Next Version:
Measure Score: Proportion
Score Type: Process
Improvement Notation:

A higher score indicates better quality


Initial encounter: The first encounter during the first 185 days of the measurement year.

Follow-up encounter: The last encounter that is at least 30 days but no more than 180 after the initial encounter.

A Functional Status Assessment (FSA) is based on administration of a validated instrument to eligible patients that asks patients to answer questions related to various domains including: pain, physical function, emotional well-being, health-related quality of life, symptom acuity.

The use of patient-reported outcomes data in eMeasures - such as this measure of functional status - demonstrates the need for the Quality Reporting Data Architecture (QRDA) to support a data attribute that indicates that the patient provided the information.


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