The 2027 Annual Update draft measure specifications are now available. Question and comment on Eligible Clinician eCQMs, Hospital - Inpatient eCQMs, and Hospital - Outpatient eCQM until December 19, 2025.
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["Patient Characteristic, Payer": "Payer Type"]
Performance/Reporting Period
2026
Value Set Description from VSAC
Clinical Focus: Categories of types of health care payer entities as defined by the US Public Health Data Consortium SOP code system
Data Element Scope: @code in CCDA r2.1 template Planned Coverage [act: identifier urn:oid:2.16.840.1.113883.10.20.22.4.129 (open)] DYNAMIC
Inclusion Criteria: All codes in the code system
Exclusion Criteria: none
Data Element Scope: @code in CCDA r2.1 template Planned Coverage [act: identifier urn:oid:2.16.840.1.113883.10.20.22.4.129 (open)] DYNAMIC
Inclusion Criteria: All codes in the code system
Exclusion Criteria: none
Constrained to codes in the Payer Type value set (2.16.840.1.114222.4.11.3591)
QDM Datatype and Definition
"Patient Characteristic, Payer"
Data elements that meet criteria using this datatype should document that the patient has one or more of the payers indicated by the QDM category and its corresponding value set.
Timing:
The relevantPeriod addresses:
- startTime – the first day of insurance coverage with the referenced payer.
- stopTime – the last day of insurance coverage with the referenced payer.
eCQMs using this data element:
Last Updated: Jul 15, 2025