CMS314v1 – HIV Viral Suppression

All patients, regardless of age, diagnosed with HIV prior to or during the first 90 days of the measurement period with at least one eligible encounter in the first 240 days of the measurement period.

In this case, a qualifying visit includes any of the following:

• Office Visit
• Outpatient Consultation
• Wellness Visit
• Face-to-Face Interaction
• Home Healthcare Services
• Preventive Care Services Established Office Visit, 18 and Up
• Preventive Care Services Initial Office Visit, 18 and Up
• Preventive Care Services, Initial Office Visit, 0 to 17
• Preventive Care, Established Office Visit, 0 to 17
• Telephone Visits
• Unlisted preventive medicine service

– NUMERATOR

Patients with a last HIV viral load test result of less than 200 copies/mL during the measurement period.

For Denominator:

• To record an encounter, navigate to Patient > Provider Note > Create Superbill. Under the ‘Procedure- CPTs’ heading, enter the encounter code.

• For documentation of HIV diagnosis, use the workflow Patient > Provider Note > Diagnoses. Click ‘Add’ and search for the relevant diagnosis. Fill out any details that are needed and once done, click ‘Save’.

For Numerator:

The HIV Viral Load test can be ordered through Patient > Provider Note > Orders > Lab. Here, click ‘Add’ and select a laboratory. Then, search for the relevant laboratory test. Fill out any details needed and once done, click ‘Save’.