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Closing the Referral Loop: Receipt of Specialist Report

Last updated: May 16, 2019

CMS Measure ID: CMS50v5
Version: 5
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 Populationinfo-icon

Denominator Exclusions:


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:


Measure Steward: Centers for Medicare and Medicaid Services (CMS)
Domain: Communication and Care Coordination
Next Version:
Previous Version:
Measure Scoring: Proportion
Measure Type: Process
Improvement Notation:

A higher score indicates better quality


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. Eligible professionalsinfo-icon 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 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 numeratorinfo-icon. Communicating the report as soon as possible will ensure the data is included in the submission to CMS.

Quality ID: 374
High Priority Measure: Yes
Data Submission Method: EHR
Specialty Measure Set: Allergy/Immunology,Cardiology,Dermatology,Emergency Medicine,Gastroenterology,General Surgery,General Oncology,Hospitalists,Neurology,Obstetrics/Gynecology,Ophthalmology,Orthopedic Surgery,Otolaryngology,Physical Medicine,Preventive Medicine,Rheumatology,Thoracic Surgery,Urology,Vascular Surgery,Mental/Behavioral Health,Plastic Surgery


Release Notes


  • ‚ÄčUpdated Copyright.

    Section: Copyright

    Source: Annual Update

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

  • Added Guidance to account for the numeratorinfo-icon actions intentionally not having an end parameter. If the consultant report is communicated after the referral but falls outside the measurement period, that would satisfy the numerator criteria as long as the communication occurs before the submission of measure results is required.

    Section: Guidance

    Source: Measure Lead

  • Updated Reference.

    Section: Reference

    Source: Measure Lead


  • Updated numerator timing from 'during 'Measurement Period'' to 'starts after start of 'Occurrence A of Intervention, Performed: Referral''. This update further connects the Referral and the communication of the Consultant Report, by requiring the correct workflow sequencing and allows additional time for closing the referral loop in instances of referrals nearing the end of the measurement period.

    Section: Numerator

    Source: Measure Lead

External Resources