Draft dQM CMS Content Implementation Guide
2025.1.0 - CI Build
Draft dQM CMS Content Implementation Guide
2025.1.0 - CI Build
Draft dQM CMS Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-cms-2025/ and changes regularly. See the Directory of published versions
| Official URL: https://madie.cms.gov/Measure/CMS50FHIRReceiptofSpecialistReport#effective-data-requirements | Version: 1.0.000 | |||
| Active | Responsible: Centers for Medicare & Medicaid Services (CMS) | Computable Name: EffectiveDataRequirements | ||
| Metadata | ||||||||||||||||||||||||||||||||||||||||||||||
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| Type | module-definition from http://terminology.hl7.org/CodeSystem/library-type | |||||||||||||||||||||||||||||||||||||||||||||
| Dependency |
Description: USQualityCore model information
Resource: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild
Canonical URL: https://madie.cms.gov/Library/USQualityCore-ModelInfo|0.1.0-cibuild |
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| Dependency |
Description: USCore model information
Resource: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived Canonical URL: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived |
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| Dependency |
Description: FHIR model information
Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1 Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1 |
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| Dependency |
Description: Library SDE
Resource: SupplementalDataElements version: 6.1.000 Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|6.1.000 |
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| Dependency |
Description: Library FHIRHelpers
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1 Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRHelpers|4.0.1 |
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| Dependency |
Description: Library USCommon
Resource: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot Canonical URL: http://hl7.org/fhir/us/cql/Library/USCoreCommon|2.0.0-ballot |
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| Dependency |
Description: Library FHIRCommon
Resource: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0 Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIRCommon|2.0.0 |
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| Dependency |
Description: Library USQualityCoreCommon
Resource: US Quality Core Common version: 0.1.0-cibuild Canonical URL: https://madie.cms.gov/Library/USQualityCoreCommon|0.1.0-cibuild |
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| Dependency |
Description: Library Status
Resource: Status version: 2.1.000 Canonical URL: https://madie.cms.gov/Library/Status|2.1.000 |
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| Dependency |
Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions) Canonical URL: http://snomed.info/sct |
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| Dependency |
Description: Code system TaskCodeSystem
Resource: Task Codes Canonical URL: http://hl7.org/fhir/CodeSystem/task-code |
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| Dependency |
Description: Code system CPT
Resource: Current Procedural Terminology (CPT®) Canonical URL: http://www.ama-assn.org/go/cpt |
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| Dependency |
Description: Value set Referral
Resource: Referral Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1046 |
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| Dependency |
Description: Value set Consultant Report
Resource: Consultant Report Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.121.12.1006 |
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| Dependency |
Description: Value set Office Visit
Resource: Office Visit Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1001 |
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| Dependency |
Description: Value set Ophthalmological Services
Resource: Ophthalmological Services Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1285 |
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| Dependency |
Description: Value set Preventive Care Services Established Office Visit, 18 and Up
Resource: Preventive Care Services Established Office Visit, 18 and Up Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1025 |
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| Dependency |
Description: Value set Preventive Care Services, Initial Office Visit, 0 to 17
Resource: Preventive Care Services, Initial Office Visit, 0 to 17 Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1022 |
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| Dependency |
Description: Value set Preventive Care Services Initial Office Visit, 18 and Up
Resource: Preventive Care Services Initial Office Visit, 18 and Up Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1023 |
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| Dependency |
Description: Value set Preventive Care, Established Office Visit, 0 to 17
Resource: Preventive Care, Established Office Visit, 0 to 17 Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.101.12.1024 |
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| Dependency |
Description: Value set Behavioral/Neuropsych Assessment
Resource: Behavioral/Neuropsych Assessment Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1023 |
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| Dependency |
Description: Value set Psych Visit Diagnostic Evaluation
Resource: Psych Visit Diagnostic Evaluation Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1492 |
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| Dependency |
Description: Value set Payer Type
Resource: Payer Type Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.114222.4.11.3591 |
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| Data Requirement |
Type: Patient
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-patient
Must Support Elements: ombCategory, detailed, text |
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| Data Requirement |
Type: ServiceRequest
Profile(s): ServiceRequest Must Support Elements: code, status, intent, authoredOn Code Filter(s): Path: code ValueSet: Referral Path: intent Code(s): [not stated]: order (order) |
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| Data Requirement |
Type: Resource
Profile(s): Resource Must Support Elements: id |
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| Data Requirement |
Type: Task
Profile(s): Task Must Support Elements: code, focus, basedOn, executionPeriod, status, reasonCode Code Filter(s): Path: code Code(s): Task Codes: fulfill (Fulfill) Path: status Code(s): [not stated]: completed (completed) Path: reasonCode ValueSet: Consultant Report |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Office Visit |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Ophthalmological Services |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Preventive Care Services Established Office Visit, 18 and Up |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Preventive Care Services, Initial Office Visit, 0 to 17 |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Preventive Care Services Initial Office Visit, 18 and Up |
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| Data Requirement |
Type: Encounter
Profile(s): Encounter Must Support Elements: type, status, period Code Filter(s): Path: type ValueSet: Preventive Care, Established Office Visit, 0 to 17 |
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| Data Requirement |
Type: Patient
Profile(s): Patient Must Support Elements: birthDate |
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| Data Requirement |
Type: Procedure
Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code ValueSet: Behavioral/Neuropsych Assessment |
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| Data Requirement |
Type: Procedure
Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code Code(s): Current Procedural Terminology (CPT®): 96156 (Health behavior assessment, or re-assessment (ie, health-focused clinical interview, behavioral observations, clinical decision making)) |
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| Data Requirement |
Type: Procedure
Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code Code(s): Current Procedural Terminology (CPT®): 96136 (Psychological or neuropsychological test administration and scoring by physician or other qualified health care professional, two or more tests, any method; first 30 minutes) |
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| Data Requirement |
Type: Procedure
Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code Code(s): Current Procedural Terminology (CPT®): 96138 (Psychological or neuropsychological test administration and scoring by technician, two or more tests, any method; first 30 minutes) |
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| Data Requirement |
Type: Procedure
Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code Code(s): Current Procedural Terminology (CPT®): 90839 (Psychotherapy for crisis; first 60 minutes) |
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| Data Requirement |
Type: Procedure
Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code ValueSet: Psych Visit Diagnostic Evaluation |
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| Data Requirement |
Type: Procedure
Profile(s): Procedure Must Support Elements: code, status, performed Code Filter(s): Path: code Code(s): Current Procedural Terminology (CPT®): 96112 (Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour) |
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| Data Requirement |
Type: Coverage
Profile(s): http://fhir.org/guides/astp/us-quality-core/StructureDefinition/us-quality-core-coverage
Must Support Elements: type, period Code Filter(s): Path: type ValueSet: Payer Type |
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| Parameters | ||||||||||||||||||||||||||||||||||||||||||||||
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