dQM CMS Content Implementation Guide
2026.1.0 - CI Build

dQM CMS Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2026.1.0 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-2026/ and changes regularly. See the Directory of published versions

## Home

Official URL: https://madie.cms.gov/ImplementationGuide/cms.madie | Version: 2026.1.0
Draft as of 2026-05-16 | Computable Name: DQMContentCMS

### Introduction

This implementation guide is a collection of draft FHIR-based electronic Clinical Quality Measures (eCQM) that conform to the FHIR Quality Measure IG

> NOTE: The measures in this implementation guide are works in progress and should not be considered final specifications or recommendations for guidance. The examples will help guide and direct the process of finding conventions and usage patterns that meet the needs of the various stakeholders in the measure development community.

### Content

This implementation guides contains electronic Clinical Quality Measure (eCQM) specifications, published as FHIR Measure and Library resources.

For a complete listing of the Measures in this IG, refer to the Measures page.

### Dependencies

IG | Package | FHIR | Comment
--- | --- | --- | ---
dQM CMS Content Implementation Guide | cms.madie#2026.1.0 | R4 |
HL7 Terminology (THO) | hl7.terminology.r4#7.2.0 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology
FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.3.0 | R4 | Automatically added as a dependency - all IGs depend on the HL7 Extension Pack
Using CQL With FHIR | hl7.fhir.uv.cql#2.0.0 | R4 |
Common CQL Artifacts for FHIR (US-Based) | hl7.fhir.us.cql#2.0.0-ballot | R4 |
2026 US Quality Core Implementation Guide | fhir.onc.us-quality-core#0.5.0 | R4 |
Quality Measure Implementation Guide | hl7.fhir.uv.cqm#1.0.0 | R4 |
FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#1.1.2 | R4 | for example references

### Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (cms.madie.r4) and R4B (cms.madie.r4b) are available.

### Global Profiles

Global Profiles:

Type | Source | Profile
Encounter | fhir.onc.us-quality-core#0.5.0 | US Quality Core Encounter
Immunization | fhir.onc.us-quality-core#0.5.0 | US Quality Core Immunization
Observation | fhir.onc.us-quality-core#0.5.0 | US Quality Core Simple Observation
Organization | fhir.onc.us-quality-core#0.5.0 | US Quality Core Organization
Patient | fhir.onc.us-quality-core#0.5.0 | US Quality Core Patient
Practitioner | fhir.onc.us-quality-core#0.5.0 | US Quality Core Practitioner
PractitionerRole | fhir.onc.us-quality-core#0.5.0 | US Quality Core PractitionerRole

All resources of these types must conform to these profiles.

### IP Statements

This publication includes IP covered under the following statements.

- The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
  Show Usage
  - Unified Code for Units of Measure (UCUM): Measure/CAUTIRateExample
- This material contains content from LOINC. LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license. LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
  Show Usage
  - LOINC: ALTLabTests, ASTLabTests... Show 5 more, AlkalinePhosphatase, NCT01980823EligibilityCriteria, SerumCreatinine, TotalBilirubin and TumorSizeObservations
- This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
  Show Usage
  - SNOMED Clinical Terms&reg; (SNOMED CT&reg;): ChemoRadiationBreastResection, CoreNeedleBiopsy, HistologicTest, NCT01980823EligibilityCriteria and TumorSizeObservations
- This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
  Show Usage
  - LibraryType: AdultOutpatientEncounters, AdvancedIllnessandFrailty... Show 24 more, BreastCancerScreeningDQMDraft, C4BBCommon, CAUTIElements, CAUTIParameters, CAUTIRate, CAUTISIR, HOB, HOBOrganismTaxonomy, Hospice, ImagingStudyFeasibilityTest, Measure/CAUTIRateExample, Measure/CAUTISIRExample, Measure/StratificationEncounterExample, Measure/StratificationPatientExample, Measure/SupportingEvidenceExample, NCT01980823EligibilityCriteria, PalliativeCare, PatientCommon, QICoreCommon, Status, StratificationEncounterExample, StratificationPatientExample, SupplementalDataElements and SupportingEvidenceExample
  - Measure Aggregate Method: Measure/CAUTIRateExample and Measure/CAUTISIRExample
  - Measure Population Type: Measure/BreastCancerScreeningDQMDraft, Measure/CAUTIRateExample... Show 4 more, Measure/CAUTISIRExample, Measure/StratificationEncounterExample, Measure/StratificationPatientExample and Measure/SupportingEvidenceExample
  - Measure Scoring: Measure/CAUTIRateExample and Measure/CAUTISIRExample
- Using RxNorm codes of type SAB=RXNORM as this specification describes does not require a UMLS license. Access to the full set of RxNorm definitions, and/or additional use of other RxNorm structures and information requires a UMLS license. The use of RxNorm in this specification is pursuant to HL7's status as a licensee of the NLM UMLS. HL7's license does not convey the right to use RxNorm to any users of this specification; implementers must acquire a license to use RxNorm in their own right.
  Show Usage
  - RxNorm: DiabetesHypercholesterolemiaMedications and StrongCYP3A4Inhibitors