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Required Test 15


Program Name: Merit-based Incentive Payment System (MIPS) Promoting Interoperability Performance Category Measure
Measure Objective: Health Information Exchange
2023/2024 Promoting Interoperability Measure: Support Electronic Referral Loops By Receiving and Reconciling Health Information:For at least one electronic summary of care record received for patient encounters during the performance period for which a MIPS eligible clinician was the receiving party of a transition of care or referral, or for patient encounters during the performance period in which the MIPS eligible clinician has never before encountered the patient, the MIPS eligible clinician conducts clinical information reconciliation for medication, medication allergy, and current problem list.

Notes:

1: The Promoting Interoperability measure require reconciliation of medications, medication allergies, and the current problem list in order to populate and record the numerator.
2: For 2023, the scenarios require the provider to receive an electronic a summary of care document and perform reconciliation during the reporting period and submit data for any continuous 90-day period within the calendar year.
3: For 2024, the scenarios require the provider to receive an electronic a summary of care document and perform reconciliation during the reporting period and submit data for any continuous 180-day period within the calendar year
4: Test data supply: ONC and Vendor-supplied. ONC provides the Test Data Scenarios and parameters; the Vendor supplies the summary of care records, where applicable.
5: Starting in 2019, for the Promoting Interoperability measure an EP may use any document template within the C-CDA standard for the purposes of the measure.
6: The Promoting Interoperability measure only requires the reconcillation of current information, not historic.
7: If the health IT module supports the reconciling of all current information from multiple electronic summary of care records in a single instance this combined information may be considered a single instance in the denominator. If the health IT module supports the reconciliation of each individual electronic summary of care record received separately, then each current record received may be considered a separate instance in the denominator. For either workflow, the completion of the reconciliation in either workflow would increment the numerator. ATLs may use different test data for health IT modules that supports the reconciling of all current information from multiple electronic summary of care records in a single instance.

Scenarios:

Denominator Criteria Numerator Criteria Results
Patient Provider Information Transitioned, Referred, New, or Existing Patient Within the Reporting Period Number of Electronic Summary of Care Records Received Number of Electronic Summary of Care Records Where Medication Reconciliation Occurred During the Performance Period Number of Electronic Summary of Care Records Where Medication Allergy Reconciliation Occurred During the Performance Period Number of Electronic Summary of Care Records Where Current Problem List Reconciliation Occurred During the Performance Period TIN A / Provider 1 TIN B / Provider 1 TIN A / Provider 2 TIN B / Provider 2 Group / TIN A Group / TIN B
Sherri Newman
4/15/1994
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Transitioned
  2. No
  3. Referred
  4. No
  1. 3
  2. 0
  3. 1
  4. 0
  1. 3
  2. N/A
  3. 1
  4. N/A
  1. 3
  2. N/A
  3. 1
  4. N/A
  1. 3
  2. N/A
  3. 1
  4. N/A
 3 / 3 0 / 0 1 / 1 0 / 0 4 / 4 0 / 0
Dianne Abbott
11/17/1984
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. No
  2. New
  3. No
  4. No
  1. 0
  2. 1
  3. 0
  4. 0
  1. N/A
  2. 1
  3. N/A
  4. N/A
  1. N/A
  2. 1
  3. N/A
  4. N/A
  1. N/A
  2. 1
  3. N/A
  4. N/A
 0 / 0 1 / 1 0 / 0 0 / 0 0 / 0 1 / 1
Joyce Copeland
4/13/1991
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. No
  2. Referred
  3. No
  4. Referred
  1. 0
  2. 2
  3. 0
  4. 4
  1. N/A
  2. 0
  3. N/A
  4. 2
  1. N/A
  2. 0
  3. N/A
  4. 3
  1. N/A
  2. 2
  3. N/A
  4. 4
 0 / 0 0 / 2 0 / 0 2 / 4 0 / 0 2 / 6
Stanley Alexander
10/17/1971
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Referred
  2. Transitioned
  3. Transitioned
  4. No
  1. 1
  2. 1
  3. 1
  4. 0
  1. 1
  2. 1
  3. 0
  4. N/A
  1. 1
  2. 1
  3. 1
  4. N/A
  1. 0
  2. 1
  3. 1
  4. N/A
 0 / 1 1 / 1 0 / 1 0 / 0 0 / 2 1 / 1
Cheryl Curtis
10/11/1983
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. New
  2. No
  3. Referred
  4. No
  1. 5
  2. 0
  3. 2
  4. 2
  1. 5
  2. N/A
  3. 2
  4. 2
  1. 5
  2. N/A
  3. 2
  4. 2
  1. 5
  2. N/A
  3. 2
  4. 2
 5 / 5 0 / 0 2 / 2 0 / 0 7 / 7 0 / 0
Cumulative Total 8 / 9 2 / 4 3 / 4 2 / 4 11 / 13 4 / 8

No actions are required for this scenario

Denominator Criteria Numerator Criteria Results
Patient Provider Information Transitioned, Referred, New, or Existing Patient Within the Reporting Period Number of Electronic Summary of Care Records Received Number of Electronic Summary of Care Records Where Medication Reconciliation Occurred During the Performance Period Number of Electronic Summary of Care Records Where Medication Allergy Reconciliation Occurred During the Performance Period Number of Electronic Summary of Care Records Where Current Problem List Reconciliation Occurred During the Performance Period TIN A / Provider 1 TIN B / Provider 1 TIN A / Provider 2 TIN B / Provider 2 Group / TIN A Group / TIN B
Kirk Nash
8/17/1981
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. New
  2. Transitioned
  3. Referred
  4. Transitioned
  1. 1
  2. 3
  3. 4
  4. 1
  1. 1
  2. 3
  3. 4
  4. 1
  1. 1
  2. 3
  3. 4
  4. 1
  1. 1
  2. 3
  3. 4
  4. 1
 1 / 1 3 / 3 4 / 4 1 / 1 5 / 5 4 / 4
Viola Padilla
8/23/1994
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Transitioned
  2. Transitioned
  3. Transitioned
  4. Transitioned
  1. 1
  2. 1
  3. 1
  4. 1
  1. 1
  2. 1
  3. 0
  4. 1
  1. 1
  2. 1
  3. 1
  4. 1
  1. 1
  2. 1
  3. 1
  4. 1
 1 / 1 1 / 1 0 / 1 1 / 1 1 / 2 2 / 2
Ralph Walton
3/19/1975
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Referred
  2. Transitioned
  3. New
  4. Transitioned
  1. 2
  2. 2
  3. 2
  4. 2
  1. 2
  2. 2
  3. 2
  4. 2
  1. 2
  2. 2
  3. 2
  4. 2
  1. 2
  2. 2
  3. 2
  4. 2
 2 / 2 2 / 2 2 / 2 2 / 2 4 / 4 4 / 4
Stanley Alexander
10/17/1971
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Transitioned
  2. Transitioned
  3. Referred
  4. Transitioned
  1. 6
  2. 3
  3. 8
  4. 4
  1. 6
  2. 3
  3. 8
  4. 4
  1. 6
  2. 3
  3. 8
  4. 4
  1. 6
  2. 3
  3. 8
  4. 4
 6 / 6 3 / 3 8 / 8 4 / 4 14 / 14 7 / 7
Cumulative Total 18 / 19 11 / 13 17 / 19 10 / 12 35 / 38 21 / 25
Denominator Criteria Numerator Criteria Results
Patient Provider Information Transitioned, Referred, New, or Existing Patient Within the Reporting Period Number of Electronic Summary of Care Records Received Number of Electronic Summary of Care Records Where Medication Reconciliation Occurred During the Performance Period Number of Electronic Summary of Care Records Where Medication Allergy Reconciliation Occurred During the Performance Period Number of Electronic Summary of Care Records Where Current Problem List Reconciliation Occurred During the Performance Period TIN A / Provider 1 TIN B / Provider 1 TIN A / Provider 2 TIN B / Provider 2 Group / TIN A Group / TIN B
Sarah Todd
3/5/1964
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. New
  2. Transitioned
  3. Referred
  4. Transitioned
  1. 1
  2. 1
  3. 1
  4. 1
  1. 0
  2. 0
  3. 1
  4. 1
  1. 0
  2. 1
  3. 0
  4. 0
  1. 0
  2. 1
  3. 0
  4. 1
 0 / 1 0 / 1 0 / 1 0 / 1 0 / 2 0 / 2
Floyd Jimenez
9/6/1982
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Transitioned
  2. Transitioned
  3. Transitioned
  4. Transitioned
  1. 1
  2. 4
  3. 2
  4. 2
  1. 1
  2. 0
  3. 0
  4. 2
  1. 0
  2. 0
  3. 0
  4. 1
  1. 1
  2. 3
  3. 0
  4. 0
 0 / 1 0 / 4 0 / 2 0 / 2 0 / 3 0 / 6
Glenn Warren
9/24/1968
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Referred
  2. New
  3. Transitioned
  4. Transitioned
  1. 3
  2. 3
  3. 3
  4. 3
  1. 0
  2. 0
  3. 0
  4. 0
  1. 0
  2. 0
  3. 0
  4. 0
  1. 3
  2. 3
  3. 0
  4. 0
 0 / 3 0 / 3 0 / 3 0 / 3 0 / 6 0 / 6
Cumulative Total 18 / 24 11 / 21 17 / 25 10 / 18 35 / 49 21 / 39

No actions are required for this scenario