CMS136v9 – Follow-Up Care for Children Prescribed ADHD Medication (ADD)

Follow-Up Care for Children Prescribed ADHD Medication (ADD)	CMS136v9	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 POPULATION CRITERIA 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.
– DENOMINATOR – 1 All patients of 6-12 years of age: Who were dispensed an ADHD medication during the Intake Period Who had a visit during the measurement period.	– NUMERATOR – 1 Patients who had at least one face-to-face visit with a practitioner with prescribing authority within 30 days after the IPSD.
– INITIAL POPULATION CRITERIA 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 – 2 All patients of 6-12 years of age: Who were dispensed an ADHD medication during the Intake Period. Who remained on the medication for at least 210 days out of the 300 days following the IPSD. Who had a visit during the measurement period.	– 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.
– DENOMINATOR EXCLUSIONS- 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 EXCLUSIONS- 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.
– APPLICATION WORKFLOW DENOMINATOR – 1: All patients of 6-12 years of age: Who were dispensed an ADHD medication during the Intake Period. To document medication, navigate to Patient > Provider Note > Prescribe. Who had a visit during the measurement period. To document a visit encounter, navigate to Patient > Provider Note > eSuperBill 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. To document this, navigate to Patient > Provider Note > Medication – DENOMINATOR EXCLUSIONS: To exclude patients diagnosed with narcolepsy at any point in their history or during the measurement period. who had an acute inpatient stay with a principal diagnosis of mental health or substance abuse during the 30 days after the IPSD. who were actively on an ADHD medication in the 120 days prior to the Index Prescription Start Date. who were in hospice care during the measurement year. Navigate to Patients > Clinical > Evaluations Inpatient Evaluations

Follow-Up Care for Children Prescribed ADHD Medication (ADD)

CMS136v9

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 POPULATION CRITERIA 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.

– DENOMINATOR – 1

All patients of 6-12 years of age:

Who were dispensed an ADHD medication during the Intake Period
Who had a visit during the measurement period.

– NUMERATOR – 1

Patients who had at least one face-to-face visit with a practitioner with prescribing authority within 30 days after the IPSD.

– INITIAL POPULATION CRITERIA 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 – 2

All patients of 6-12 years of age:

Who were dispensed an ADHD medication during the Intake Period.
Who remained on the medication for at least 210 days out of the 300 days following the IPSD.
Who had a visit during the measurement period.

– 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.

– DENOMINATOR EXCLUSIONS- 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 EXCLUSIONS- 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.

– APPLICATION WORKFLOW

DENOMINATOR – 1:

All patients of 6-12 years of age:

Who were dispensed an ADHD medication during the Intake Period. To document medication, navigate to Patient > Provider Note > Prescribe.

Who had a visit during the measurement period. To document a visit encounter, navigate to Patient > Provider Note > eSuperBill

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:

– DENOMINATOR EXCLUSIONS:

To exclude patients

diagnosed with narcolepsy at any point in their history or during the measurement period.
who had an acute inpatient stay with a principal diagnosis of mental health or substance abuse during the 30 days after the IPSD.
who were actively on an ADHD medication in the 120 days prior to the Index Prescription Start Date.
who were in hospice care during the measurement year.

Navigate to Patients > Clinical > Evaluations

CMS136v9 – Follow-Up Care for Children Prescribed ADHD Medication (ADD)

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