dQM QICore Content Implementation Guide
2025.0.0 - CI Build

dQM QICore Content Implementation Guide, published by cqframework. This guide is not an authorized publication; it is the continuous build for version 2025.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/dqm-content-qicore-2025/ and changes regularly. See the Directory of published versions

Library: Library

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
Type http://terminology.hl7.org/CodeSystem/library-type#module-definition
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: extension
Data Requirement Type: Resource
Profile(s): Resource
Must Support Elements: id
Data Requirement Type: Resource
Profile(s): Resource
Must Support Elements: id.value
Data Requirement Type: Task
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-task
Must Support Elements: code, focus, basedOn, executionPeriod, status, status.value, reasonCode
Code Filter(s):
Path: code
Code(s): Task Codes: fulfill (Fulfill)
Data Requirement Type: ServiceRequest
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-servicerequest
Must Support Elements: code, status, status.value, intent, intent.value, authoredOn, authoredOn.value
Code Filter(s):
Path: code
ValueSet: Referral
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: Office Visit
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: Ophthalmological Services
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: Preventive Care Services Established Office Visit, 18 and Up
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: Preventive Care Services, Initial Office Visit, 0 to 17
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: Preventive Care Services Initial Office Visit, 18 and Up
Data Requirement Type: Encounter
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter
Must Support Elements: type
Code Filter(s):
Path: type
ValueSet: Preventive Care, Established Office Visit, 0 to 17
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: birthDate
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: birthDate.value
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Behavioral or Neuropsych Assessment
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code
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))
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code
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)
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code
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)
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code
Code Filter(s):
Path: code
Code(s): Current Procedural Terminology (CPT®): 90839 (Psychotherapy for crisis; first 60 minutes)
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code
Code Filter(s):
Path: code
ValueSet: Psych Visit Diagnostic Evaluation
Data Requirement Type: Procedure
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-procedure
Must Support Elements: code
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)
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: url
Data Requirement Type: Coverage
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-coverage
Must Support Elements: type, period
Code Filter(s):
Path: type
ValueSet: Payer Type
Data Requirement Type: Patient
Profile(s): http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient
Must Support Elements: url, extension
Parameters
Name Use Card. Type Documentation
Measurement Period In 0..1 Period
SDE Sex Out 0..1 Coding
Numerator Out 0..1 boolean
Denominator Out 0..1 boolean
SDE Payer Out 0..* Resource
Initial Population Out 0..1 boolean
SDE Ethnicity Out 0..1 Resource
SDE Race Out 0..1 Resource
Citations and References
Dependency Description: Library SDE
Resource: SupplementalDataElements version: 5.1.000
Canonical URL: https://madie.cms.gov/Library/SupplementalDataElements|5.1.000
Dependency Description: Library FHIRHelpers
Resource: FHIRHelpers version: 4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Library QICoreCommon
Resource: QICoreCommon version: 4.0.000
Canonical URL: https://madie.cms.gov/Library/QICoreCommon|4.0.000
Dependency Description: Library FHIRHelpers
Resource: FHIRHelpers version: 4.4.000
Canonical URL: https://madie.cms.gov/Library/FHIRHelpers|4.4.000
Dependency Description: Library Status
Resource: Status version: 1.15.000
Canonical URL: https://madie.cms.gov/Library/Status|1.15.000
Dependency Description: Code system SNOMEDCT
Resource: SNOMED CT (all versions)
Canonical URL: http://snomed.info/sct
Dependency Description: Code system TaskCodeSystem
Resource: Task Codes
Canonical URL: http://hl7.org/fhir/CodeSystem/task-code
Dependency Description: Code system CPT
Resource: Current Procedural Terminology (CPT®)
Canonical URL: http://www.ama-assn.org/go/cpt
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
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
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
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
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
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
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
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
Dependency Description: Value set Behavioral/Neuropsych Assessment
Resource: Behavioral or Neuropsych Assessment
Canonical URL: http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1023
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
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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