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Required Test 7


Program Name: Merit-based Incentive Payment System (MIPS) Promoting Interoperability Performance Category Measure
Measure Objective: Health Information Exchange
2026 Promoting Interoperability Measure: Support Electronic Referral Loops By Sending Health Information:For at least one transition of care or referral, the MIPS eligible clinician that transitions or refers their patient to another setting of care or health care provider - (1) creates a summary of care record using certified electronic health record technology (CEHRT); and (2) electronically exchanges the summary of care record.

Notes:

1: The scenarios for the Promoting Interoperability measure require the provider to create and transmit/exchange a summary of care record and to confirm receipt of the transmitted/exchanged summary of care record and submit data for a minimum of 180 consecutive days within the calendar year.
2: Test data supply: ONC and Vendor-supplied. ONC provides the Test Data Scenarios and parameters; the Vendor supplies the summary of care records within the parameters.
3: The name of this measure changed from Transitions of Care to Support Electronic Referral Loops by Sending Health Information. No other changes were made to the test data.
4: 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.

Scenarios:

Denominator Criteria Numerator Criteria Results
Patient Provider Information Transition of Care or Referral Within Reporting/Performance Period Summary of Care Record (including all CMS required information or indication of none) Created and Transmitted / Exchanged Electronically During Calendar Year Receipt of Summary of Care Record Confirmed During Calendar Year TIN A / Provider 1 TIN B / Provider 1 TIN A / Provider 2 TIN B / Provider 2 Group / TIN A Group / TIN B
Sandra Haynes
9/1/1991
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. No
  3. No
  4. Yes
  1. Yes
  2. No
  3. No
  4. No
  1. Yes
  2. No
  3. No
  4. No
 1 / 1 0 / 0 0 / 0 0 / 1 1 / 1 0 / 1
Denise Duncan
10/11/1981
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. No
  3. Yes
  4. Yes
  1. No
  2. No
  3. Yes
  4. Yes
  1. No
  2. No
  3. Yes
  4. Yes
 0 / 0 0 / 0 1 / 1 1 / 1 1 / 1 1 / 1
Maxine Thomas
1/25/1977
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. No
  3. No
  4. No
  1. Yes
  2. No
  3. No
  4. No
  1. No
  2. No
  3. No
  4. No
 0 / 1 0 / 0 0 / 0 0 / 0 0 / 1 0 / 0
Daryl Roberson
5/7/1989
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. No
  3. Yes
  4. Yes
 1 / 1 0 / 1 1 / 1 1 / 1 2 / 2 1 / 2
Marilyn Zimmerman
4/25/1989
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. Yes
  3. Yes
  4. No
  1. No
  2. Yes
  3. Yes
  4. No
  1. No
  2. Yes
  3. Yes
  4. No
 0 / 1 1 / 1 1 / 1 0 / 0 1 / 2 1 / 1
Cumulative Total 2 / 4 1 / 2 3 / 3 2 / 3 5 / 7 3 / 5

No actions are required for this scenario

Denominator Criteria Numerator Criteria Results
Patient Provider Information Transition of Care or Referral Within Reporting/Performance Period Summary of Care Record (including all CMS required information or indication of none) Created and Transmitted / Exchanged Electronically During Calendar Year Receipt of Summary of Care Record Confirmed During Calendar Year TIN A / Provider 1 TIN B / Provider 1 TIN A / Provider 2 TIN B / Provider 2 Group / TIN A Group / TIN B
Warren Mills
6/6/1965
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. Yes
  3. Yes
  4. Yes
 1 / 1 1 / 1 1 / 1 1 / 1 2 / 2 2 / 2
Myrtle Quinn
11/17/1999
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. Yes
  3. Yes
  4. Yes
 1 / 1 1 / 1 1 / 1 1 / 1 2 / 2 2 / 2
Barry Harper
5/24/1994
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. Yes
  3. Yes
  4. Yes
 1 / 1 1 / 1 1 / 1 1 / 1 2 / 2 2 / 2
Daryl Roberson
5/7/1989
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. Yes
  3. Yes
  4. Yes
 1 / 1 1 / 1 1 / 1 1 / 1 2 / 2 2 / 2
Cumulative Total 6 / 8 5 / 6 7 / 7 6 / 7 13 / 15 11 / 13
Denominator Criteria Numerator Criteria Results
Patient Provider Information Transition of Care or Referral Within Reporting/Performance Period Summary of Care Record (including all CMS required information or indication of none) Created and Transmitted / Exchanged Electronically During Calendar Year Receipt of Summary of Care Record Confirmed During Calendar Year TIN A / Provider 1 TIN B / Provider 1 TIN A / Provider 2 TIN B / Provider 2 Group / TIN A Group / TIN B
Agnes Simon
5/21/1972
Sex: F
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. Yes
  2. No
  3. No
  4. Yes
  1. No
  2. No
  3. No
  4. No
 0 / 1 0 / 1 0 / 1 0 / 1 0 / 2 0 / 2
Edward Armstrong
8/10/1998
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. No
  2. No
  3. No
  4. No
  1. No
  2. No
  3. No
  4. No
 0 / 1 0 / 1 0 / 1 0 / 1 0 / 2 0 / 2
Bernard Lawson
6/21/1994
Sex: M
  1. TIN A/Provider 1
  2. TIN B/Provider 1
  3. TIN A/Provider 2
  4. TIN B/Provider 2
  1. Yes
  2. Yes
  3. Yes
  4. Yes
  1. No
  2. Yes
  3. Yes
  4. No
  1. No
  2. No
  3. No
  4. No
 0 / 1 0 / 1 0 / 1 0 / 1 0 / 2 0 / 2
Cumulative Total 6 / 11 5 / 9 7 / 10 6 / 10 13 / 21 11 / 19

No actions are required for this scenario