Measure: CMS136

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

Measure Versions

eMeasure Code	Measure Year	Full Version Number	Title
CMS136v13	2024	13.0.000	Follow-Up Care for Children Prescribed ADHD Medication (ADD)
CMS136v12	2023	12	Follow-Up Care for Children Prescribed ADHD Medication (ADD)
CMS136v11	2022	11.1.000	Follow-Up Care for Children Prescribed ADHD Medication (ADD)
CMS136v10	2021	10.2.000	Follow-Up Care for Children Prescribed ADHD Medication (ADD)
CMS136v9	2020	9.1.000	Follow-Up Care for Children Prescribed ADHD Medication (ADD)
CMS136v8	2019	8.3.000	Follow-Up Care for Children Prescribed ADHD Medication (ADD)
CMS136v7	2018	7.1.000	Follow-Up Care for Children Prescribed ADHD Medication (ADD)
CMS136v6	2017	6.0.000	ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication

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.

Guidance

Patient Group Definitions

Group	Description	Instructions Links
Initial Population	Initial Population 1: Children 6-12 years of age as of the Intake Period who were prescribed an ADHD medication during the Intake Period and who had a visit during the measurement period. Children are removed if they were actively on ADHD medication in the 120 days prior to the IPSD, or had an acute inpatient stay with a principal diagnosis of mental, behavioral or neurodevelopmental disorder during the Initiation Phase. Initial Population 2: Children 6-12 years of age as of the Intake Period who were prescribed an ADHD medication during the Intake Period and remained on the medication for at least 210 days during the 301-day period, beginning on the IPSD through 300 days after the IPSD, and who had a visit during the measurement period. Children are removed if they were actively on ADHD medication in the 120 days prior to the IPSD, or had an acute inpatient stay with a principal diagnosis of mental, behavioral or neurodevelopmental disorder during the Continuation and Maintenance Phase.	Webchart Instructions
Denominator	Equals Initial Population	Webchart Instructions
Denominator Exclusions	Exclude patients diagnosed with narcolepsy at any point in their history or during the measurement period. Exclude patients who are in hospice care for any part of the measurement period.	Webchart Instructions
Numerator	Numerator 1: Patients who had at least one visit with a practitioner with prescribing authority during the Initiation Phase. Numerator 2: Patients who had at least one visit with a practitioner with prescribing authority during the Initiation Phase, and at least two follow-up visits during the 31-300 days after the IPSD.	Webchart Instructions
Numerator Exclusions	Not Applicable	Webchart Instructions
Denominator Exceptions	None

Details

Full eMeasure Code	eMeasure Identifier	Measure Year	Version	NQF #	GUID
CMS136v12	136	2023	12	N/A	703cc49b-b653-4885-80e8-245a057f5ae9

Steward	Developer	Endorsed By
National Committee for Quality Assurance	National Committee for Quality Assurance	None

Scoring Method	Measure Type	Stratification	Risk Adjustment
Proportion	Process	None	None

Rate Aggregation

None

Improvement Notation

Higher score indicates better quality

Rationale

Clinical Recommendation Statement

Definition

Transmission Format

Applicable Value Sets

Category	Value Set	OID
Diagnosis	Narcolepsy	2.16.840.1.113883.3.464.1003.114.12.1011
Encounter, Performed	Behavioral Health Follow-up Visit	2.16.840.1.113883.3.464.1003.101.12.1054
Encounter, Performed	Encounter Inpatient	2.16.840.1.113883.3.666.5.307
Encounter, Performed	Home Healthcare Services	2.16.840.1.113883.3.464.1003.101.12.1016
Encounter, Performed	Hospice Encounter	2.16.840.1.113883.3.464.1003.1003
Encounter, Performed	Hospital Observation Care - Initial	2.16.840.1.113883.3.464.1003.101.12.1002
Encounter, Performed	Office Visit	2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed	Online Assessments	2.16.840.1.113883.3.464.1003.101.12.1089
Encounter, Performed	Outpatient Consultation	2.16.840.1.113883.3.464.1003.101.12.1008
Encounter, Performed	Preventive Care - Established Office Visit, 0 to 17	2.16.840.1.113883.3.464.1003.101.12.1024
Encounter, Performed	Preventive Care Services - Group Counseling	2.16.840.1.113883.3.464.1003.101.12.1027
Encounter, Performed	Preventive Care Services-Individual Counseling	2.16.840.1.113883.3.464.1003.101.12.1026
Encounter, Performed	Preventive Care- Initial Office Visit, 0 to 17	2.16.840.1.113883.3.464.1003.101.12.1022
Encounter, Performed	Psych Visit - Diagnostic Evaluation	2.16.840.1.113883.3.526.3.1492
Encounter, Performed	Psych Visit - Psychotherapy	2.16.840.1.113883.3.526.3.1496
Encounter, Performed	Psychotherapy and Pharmacologic Management	2.16.840.1.113883.3.464.1003.101.12.1055
Encounter, Performed	Telephone Visits	2.16.840.1.113883.3.464.1003.101.12.1080
Intervention, Order	Hospice Care Ambulatory	2.16.840.1.113883.3.526.3.1584
Intervention, Performed	Hospice Care Ambulatory	2.16.840.1.113883.3.526.3.1584
Medication, Active	ADHD Medications	2.16.840.1.113883.3.464.1003.196.12.1171
Medication, Order	ADHD Medications	2.16.840.1.113883.3.464.1003.196.12.1171
Patient Characteristic Ethnicity	Ethnicity	2.16.840.1.114222.4.11.837
Patient Characteristic Payer	Payer	2.16.840.1.114222.4.11.3591
Patient Characteristic Race	Race	2.16.840.1.114222.4.11.836
Patient Characteristic Sex	ONC Administrative Sex	2.16.840.1.113762.1.4.1