eCQM Title

Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

eCQM Identifier (Measure Authoring Tool) 155 eCQM Version number 8.1.000
NQF Number Not Applicable GUID 0b63f730-25d6-4248-b11f-8c09c66a04eb
Measurement Period January 1, 20XX through December 31, 20XX
Measure Steward National Committee for Quality Assurance
Measure Developer National Committee for Quality Assurance
Endorsed By None
Percentage of patients 3-17 years of age who had an outpatient visit with a Primary Care Physician (PCP) or Obstetrician/Gynecologist (OB/GYN) and who had evidence of the following during the measurement period. Three rates are reported.

 - Percentage of patients with height, weight, and body mass index (BMI) percentile documentation
 - Percentage of patients with counseling for nutrition
 - Percentage of patients with counseling for physical activity
This Physician Performance Measure (Measure) and related data specifications are owned and were developed by the National Committee for Quality Assurance (NCQA). NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. NCQA holds a copyright in the Measure. The Measure can be reproduced and distributed, without modification, for noncommercial purposes (e.g., use by healthcare providers in connection with their practices) without obtaining approval from NCQA. Commercial use is defined as the sale, licensing, or distribution of the Measure for commercial gain, or incorporation of the Measure into a product or service that is sold, licensed or distributed for commercial gain. All commercial uses or requests for modification must be approved by NCQA and are subject to a license at the discretion of NCQA. (C) 2012-2019 National Committee for Quality Assurance. All Rights Reserved. 

Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-2018 American Medical Association. LOINC(R) copyright 2004-2018 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2018 International Health Terminology Standards Development Organisation. ICD-10 copyright 2018 World Health Organization. All Rights Reserved.
The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
Measure Scoring Proportion
Measure Type Process
Report a total score, and each of the following strata:
Stratum 1 - Patients age 3-11  
Stratum 2 - Patients age 12-17
Risk Adjustment
Rate Aggregation
Over the last three decades, childhood obesity has more than doubled in children and tripled in adolescents. Approximately 15 percent of children and adolescents in the United States are overweight and 17 percent are obese (Fryar, Carroll, & Ogden, 2014). Childhood obesity has both immediate and long-term effects on health and well-being. 

Children who are obese are more likely to be obese as adults and are therefore at risk for adult health problems, such as heart disease, type 2 diabetes, stroke and several types of cancer (Centers for Disease Control and Prevention, 2013.

The direct medical costs associated with childhood obesity total about $19,000 per child, contributing to the $14 billion spent on care related to childhood obesity in the United States (Finkelstein, Graham, & Malhotra, 2014). 

Since obesity can become a lifelong health issue, it is important to screen for obesity in children and adolescents, and to provide interventions that promote weight loss (U.S. Preventive Services Task Force, 2017).
Clinical Recommendation Statement
U.S. Preventive Services Task Force (2017) - The task force recommends that clinicians screen for obesity in children and adolescents 6 years and older and offer or refer them to comprehensive, intensive behavioral interventions to promote improvements in weight status. (B recommendation)
American Academy of Pediatrics – Bright Futures (Hagan, Shaw, & Duncan, 2017) - 

- Plot and assess BMI percentiles routinely for early recognition of overweight and obesity. 
- Assess barriers to healthy eating and physical activity. 
- Provide anticipatory guidance for nutrition and physical activity.
Improvement Notation
Higher score indicates better quality
Centers for Disease Control and Prevention. (2013). Adolescent and school health: Childhood obesity facts. Retrieved from
Finkelstein, E. A., Graham, W. C. K., & Malhotra, R. (2014). Lifetime direct medical costs of childhood obesity. Pediatrics, 133(5), 854-862. Retrieved from
Fryar, C. D., Carroll, M. D., & Ogden, C. L. (2014). Prevalence of overweight and obesity among children and adolescents: United States, 1963-1965 through 2011-2012. Health E-Stats. Retrieved from
Hagan, J. F., Shaw, J. S., & Duncan, P. M. (eds.). (2017). Bright futures: Guidelines for health supervision of infants, children, and adolescents, 4th ed. Elk Grove Village, IL: American Academy of Pediatrics.
U.S. Preventive Services Task Force. (2017). Screening and interventions for overweight in children and adolescents: Recommendation statement. Rockville, MD: Agency for Healthcare Research and Quality. 
The visit must be performed by a PCP or OB/GYN. 
Because BMI norms for youth vary with age and sex, this measure evaluates whether BMI percentile, rather than an absolute BMI value, is assessed.
Transmission Format
Initial Population
Patients 3-17 years of age with at least one outpatient visit with a primary care physician (PCP) or an obstetrician/gynecologist (OB/GYN) during the measurement period
Equals Initial Population
Denominator Exclusions
Patients who have a diagnosis of pregnancy during the measurement period.

Exclude patients whose hospice care overlaps the measurement period.
Numerator 1: Patients who had a height, weight and body mass index (BMI) percentile recorded during the measurement period
Numerator 2: Patients who had counseling for nutrition during the measurement period
Numerator 3: Patients who had counseling for physical activity during the measurement period
Numerator Exclusions
Not Applicable
Denominator Exceptions
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity and sex

Table of Contents

Population Criteria




Data Criteria (QDM Data Elements)

Supplemental Data Elements

Risk Adjustment Variables

Measure Set