CMS137v8 – Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

Patients age 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency during a visit between January 1 and November 14 of the measurement period.

Patients age 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency during a visit between January 1 and November 14 of the measurement period.

Initiation of treatment includes either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis.

Patients age 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency during a visit between January 1 and November 14 of the measurement period.

Patients age 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency during a visit between January 1 and November 14 of the measurement period.

Engagement in ongoing treatment includes two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention (i.e., engagement for these members cannot be satisfied with medication treatment alone).

Patients with a previous active diagnosis of alcohol, opioid or other drug abuse or dependence in the 60 days prior to the first episode of alcohol or drug dependence

Exclude patients whose hospice care overlaps the measurement period.

For Denominator 1

Patients with 13 years of age and older who were diagnosed with a new episode of alcohol in the first 11 months of the measurement period. To record visit and diagnosis, navigate to Patient > Provider Note > Diagnosis.

For Numerator Stratum 1

Patients who initiated treatment within 14 days of the diagnosis are included in Numerator stratum 1 of this measure.

Any one of the following must be documented.

• Alcohol and Drug Dependence Treatment (Patient > Clinical > Evaluations)
• Psych Visit – Psychotherapy (Patient > Provider Note > eSuperbill > Procedures – CPTs)

To learn more about how to add Evaluations, click here.

Denominator Exclusions:

Patients with a previous active diagnosis of alcohol or drug dependence in the 60 days prior to the first episode of alcohol or drug dependence are included in Denominator Exclusion.