CMS FHIR Quality Measure Development IG
0.8.0-cibuild - CI Build
CMS FHIR Quality Measure Development IG
0.8.0-cibuild - CI Build
CMS FHIR Quality Measure Development IG, published by Centers for Medicare & Medicaid Services (CMS). This guide is not an authorized publication; it is the continuous build for version 0.8.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cms-qmd/ and changes regularly. See the Directory of published versions
MADiE Measure is derived from FHIR Measure. Its purpose is to support general measure development in MADiE.
CMS Publishable Measure is derived from the MADiE Measure profile and defines requirements for CMS published program measures.
While the CMS measure profile is derived from FHIR Measure, CMS measures must also conform to profiles and guidance in the HL7 Quality Measure Implementation Guide (QMIG). The Using CQL topic of that guide defines conformance requirements for the CQL a measure depends on. The requirements governing how that CQL is organized and referenced are summarized below; requirements governing how it is written are covered in the CMS FHIR-based CQL Style Guide, and query patterns in the Patterns topic.
CQL used by a Measure SHALL be contained in a CQL library, and every library SHALL carry a library declaration. The library identifier SHALL be a valid unquoted identifier containing only alphanumeric characters, with no underscores.
library EXM146 version '4.0.0'
Libraries used by measures SHALL declare a version, and that version SHALL follow the <major>.<minor>.<patch> convention of semantic versioning. Patch changes retain forward and backward compatibility and are used only to fix issues; minor changes retain backward compatibility and may add functionality; major changes may break compatibility.
For measures in draft status a version label MAY be included, in which case it SHALL follow <major>.<minor>.<patch>-<label>.
All CQL expressions referenced by a Measure SHALL be contained within a single library, so that the expression identifiers named in the Measure need not be qualified. That library may in turn include others, and every included library SHALL use a called clause. The called-alias for a given library SHOULD be the same everywhere it is included.
include Common version '2.0.0' called Common
Libraries SHOULD use namespaces. Where one is used, the root of the CQL namespace SHALL match the root of the url of the Library resource carrying the library. A library declared without a namespace is treated as belonging to a public global namespace for resolution within a given environment.
library CMS.Common version '2.0.0'
Code systems and value sets referenced from CQL SHALL be identified by canonical URL — see Code Systems and Value Sets. Version information MAY be included, and when it is, it is given using the version clause of the declaration or a versioned canonical reference.
codesystem "SNOMED CT:20240901": 'http://snomed.info/sct'
version 'http://snomed.info/sct/731000124108/version/20240901'
valueset "Acute Pharyngitis": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.102.12.1011'
As a best practice, terminology versions are specified externally using a version manifest rather than pinned in the library — see the Manifest Guidance topic. The local identifier for a value set should match its name in the Value Set Authority Center (VSAC); where two value sets share a name, add a qualifying suffix so the human-readable name is preserved while the reference stays unique within the library.
CQL is carried into a measure package using FHIR Library resources, referenced from the Measure through its library element, with the CQL itself in the Library’s content element. Translated ELM may be included alongside the CQL; see Library Resources and Translation to ELM.
CMS test cases must conform to the CMSTestCase profile.