CMS Measure ID:CMS136v7
Version:7
NQF Number:0108
Measure Description:Percentage of children 6-12 years of age and newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported.
a. Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.
b. Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.
Initial Patient Population:Initial Population 1: Children 6-12 years of age who were dispensed an ADHD medication during the Intake Period and who had a visit during the measurement period.
Initial Population 2: Children 6-12 years of age who were dispensed an ADHD medication during the Intake Period and who remained on the medication for at least 210 days out of the 300 days following the IPSD, and who had a visit during the measurement period.
Denominator Statement:Equals Initial Population
Denominator Exclusions:Denominator Exclusion 1: Exclude patients diagnosed with narcolepsy at any point in their history or during the measurement period.
Exclude patients who had an acute inpatient stay with a principal diagnosis of mental health or substance abuse during the 30 days after the IPSD.
Exclude patients who were actively on an ADHD medication in the 120 days prior to the Index Prescription Start Date.
Exclude patients who were in hospice care during the measurement year.
Denominator Exclusion 2: Exclude patients diagnosed with narcolepsy at any point in their history or during the measurement period.
Exclude patients who had an acute inpatient stay with a principal diagnosis of mental health or substance abuse during the 300 days after the IPSD.
Exclude patients who were actively on an ADHD medication in the 120 days prior to the Index Prescription Start Date.
Exclude patients who were in hospice care during the measurement year.
Numerator Statement:Numerator 1: Patients who had at least one face-to-face visit with a practitioner with prescribing authority within 30 days after the IPSD.
Numerator 2: Patients who had at least one face-to-face visit with a practitioner with prescribing authority during the Initiation Phase, and at least two follow-up visits during the Continuation and Maintenance Phase. One of the two visits during the Continuation and Maintenance Phase may be a telephone visit with a practitioner.
Numerator Exclusions:Not Applicable
Denominator Exceptions:None