CMS128v10 – Anti-depressant Medication Management

Patients 18 years of age and older who were dispensed antidepressant medications within 245 days (8 months) prior to the measurement period through the first 120 days (4 months) of the measurement period, and were diagnosed with major depression 60 days prior to, or 60 days after the dispensing event and had a visit 60 days prior to, or 60 days after the dispensing event.

Equals initial population

Patients who have received antidepressant medication for at least 84 days (12 weeks) of continuous treatment during the 114-day period following the Index Prescription Start Date.

Index Prescription Start Date (IPSD): The earliest prescription dispensing event for an antidepressant medication during the period of 245 days prior to the start of the measurement period through 120 days after the start of the measurement period.

Equals initial population

Patients who have received antidepressant medications for at least 180 days (6 months) of continuous treatment during the 231-day period following the Index Prescription Start Date.

• Patients who were actively on an antidepressant medication in the 105 days prior to the Index Prescription Start Date.
• Exclude patients who are in hospice care for any part of the measurement period.

For Denominator: 

Include patients aged 18 years and older at the start of the measurement period with a qualifying encounter within 60 days of start of the ‘Normalize Interval (24 days before or 120 days after the start of measurement period)’. Additionally, the patient should have antidepressant dispensed during the ‘Normalize Interval’ with a diagnosis of ‘Major Depression’. The start of major depression prevalence period should be within 60 days of the start of ‘Normalize Interval’.

To document the diagnosis for major depression, use the workflow Patient > Provider Note > Diagnoses, and click ‘Add’. Search for the major depression diagnosis, add the diagnosis details and click ‘Save’. Then click ‘Accept’ and the diagnosis is added to the provider note.

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

To document antidepressant medication dispensed during the index prescription period, navigate to Patient > Provider Note > Prescription. Click ‘Add’ and search for the prescription. Complete the prescription details and click ‘Prescribe’.

For Numerator 1:

Include patients who have received antidepressant medication for at least 84 days (12 weeks) of continuous treatment during the 114-day period following the Index Prescription Start Date. To document the medication, use the workflow Patient > Provider Note > Medications. Click ‘Add’ and search for the medication. Complete the medication details and click ‘Save’.

For Numerator 2:

Include patients who have received antidepressant medication for at least 180 days (6 months) of continuous treatment during the 231-day period following the Index Prescription Start Date. To document the medication, use the workflow Patient > Provider Note > Medications. Click ‘Add’ and search for the medication. Complete the medication details and click ‘Save’.

For Denominator Exclusions:

Exclude patients satisfying any of the following conditions:

• Patients who were actively on an antidepressant medication in the 105 days prior to the Index Prescription Start Date. To document the medication, use the workflow Patient > Provider Note > Medications. Click ‘Add’ and search for the medication. Complete the medication details and click ‘Save’.
• Patients who received hospice care during the measurement year. To document that patient is receiving hospice care outside of a hospital or long term care facility, navigate to Patient > Clinical > Evaluations. Use the below mentioned codes to order or perform an intervention:
  • 385763009: Hospice Care (Regime/Therapy)
  • 385765002: Hospice Care Management (Procedure)

• • To document an encounter inpatient, navigate to Patient > Clinical > Evaluations