PT/OT Preferred Specialty Measure Set - CMS

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2016 Physical Therapy/Occupational Therapy Preferred Specialty Measure SetPQRS#NQF#ReportingMethodNational Quality StrategyDomainMeasure Title: DescriptionMeasures Primarily Relevant to Occupational Therapy1280421Claims,Registry,GRPO (WebInterface),EHR,MeasuresGroupsCommunity/ Population HealthPreventive Care and Screening:Body Mass Index (BMI) Screeningand Follow-Up Plan: Percentage ofpatients aged 18 years and olderwith a BMI documented during thecurrent encounter or during theprevious six months AND with aBMI outside of normal parameters afollow-up plan is documented duringthe encounter or during the previoussix months of the current encounterNormal Parameters: Age 65 yearsand older BMI 23 and 30 kg/m2;Age 18 – 64 years BMI 18.5 and 25 roupsEHR, GPRO(Web Interface)Patient ion and CareCoordinationDocumentation of CurrentMedications in the MedicalRecord: Percentage of visits forpatients aged 18 years and older forwhich the eligible professionalattests to documenting a list ofcurrent medications using allimmediate resources available onthe date of the encounter. This listmust include ALL knownprescriptions, over-the-counters,herbals, and vitamin/mineral/dietary(nutritional) supplements AND mustcontain the medications’ name,dosage, frequency and route ofadministrationPain Assessment and Follow-Up:Percentage of visits for patientsaged 18 years and older withdocumentation of a painassessment using a standardizedtool(s) on each visit ANDdocumentation of a follow-up planwhen pain is presentPage 1 of 8

2016 Physical Therapy/Occupational Therapy Preferred Specialty Measure SetPQRS#134154155NQF#ReportingMethodNational Quality StrategyDomain0418Claims,Registry, EHR,GPRO (WebInterface),MeasuresGroupsCommunity/Population Health0101Claims,Registry,MeasuresGroupsPatient ion and CareCoordination181N/AClaims,RegistryPatient Safety1822624Claims,RegistryCommunication and CareCoordination01/06/2016Measure Title: DescriptionPreventive Care and Screening:Screening for Clinical Depressionand Follow-Up Plan: Percentage ofpatients aged 12 years and olderscreened for clinical depression onthe date of encounter using an ageappropriate standardizeddepression screening tool AND, ifpositive, a follow-up plan isdocumented on the date of thepositive screenFalls: Risk Assessment:Percentage of patients aged 65years and older with a history offalls who had a risk assessment forfalls completed within 12 monthsFalls: Plan of Care: Percentage ofpatients aged 65 years and olderwith a history of falls who had a planof care for falls documented within12 monthsElder Maltreatment Screen andFollow-Up Plan: Percentage ofpatients aged 65 years and olderwith a documented eldermaltreatment screen using an ElderMaltreatment Screening Tool on thedate of encounter AND adocumented follow-up plan on thedate of the positive screenFunctional OutcomeAssessment: Percentage of visitsfor patients aged 18 years and olderwith documentation of a currentfunctional outcome assessmentusing a standardized functionaloutcome assessment tool on thedate of encounter ANDdocumentation of a care plan basedon identified functional outcomedeficiencies on the date of theidentified deficienciesPage 2 of 8

2016 Physical Therapy/Occupational Therapy Preferred Specialty Measure ional Quality StrategyDomainCommunication and CareCoordinationCommunication and CareCoordinationCommunication and CareCoordinationCommunication and CareCoordinationMeasure Title: DescriptionFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with KneeImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the knee in which thechange in their Risk-AdjustedFunctional Status is measuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with HipImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the hip in which the changein their Risk-Adjusted FunctionalStatus is measuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with Lower Leg, Footor Ankle Impairments: Percentageof patients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the lower leg, foot or ankle inwhich the change in their RiskAdjusted Functional Status ismeasuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with Lumbar SpineImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the lumbar spine in whichthe change in their Risk-AdjustedFunctional Status is measuredPage 3 of 8

2016 Physical Therapy/Occupational Therapy Preferred Specialty Measure stry, EHR,GPRO (WebInterface),MeasuresGroupsNational Quality StrategyDomainCommunication and CareCoordinationCommunication and CareCoordinationCommunication and CareCoordinationCommunity/Population HealthMeasure Title: DescriptionFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with ShoulderImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the shoulder in which thechange in their Risk-AdjustedFunctional Status is measuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with Elbow, Wrist orHand Impairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the elbow, wrist or hand inwhich the change in their RiskAdjusted Functional Status ismeasuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with Neck, Cranium,Mandible, Thoracic Spine, Ribs,or Other General OrthopedicImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the neck, cranium, mandible,thoracic spine, ribs, or other generalorthopedic impairment in which thechange in their Risk-AdjustedFunctional Status is measuredPreventive Care and Screening:Tobacco Use: Screening andCessation Intervention:Percentage of patients aged 18years and older who were screenedfor tobacco use one or more timeswithin 24 months AND who receivedcessation counseling intervention ifidentified as a tobacco userPage 4 of 8

2016 Physical Therapy/Occupational Therapy Preferred Specialty Measure sGroupsNational Quality StrategyDomainCommunity/Population HealthMeasure Title: DescriptionPreventive Care and Screening:Unhealthy Alcohol Use:Screening & Brief Counseling:Percentage of patients aged 18years and older who were screenedat least once within the last 24months for unhealthy alcohol useusing a systematic screeningmethod AND who received briefcounseling if identified as anunhealthy alcohol userMeasures Primarily Relevant to Physical Therapy1260417Registry,MeasuresGroupsEffective Clinical Care1270416RegistryEffective Clinical Care0421Claims,Registry,GPRO ion Health12801/06/2016Diabetes Mellitus: Diabetic Footand Ankle Care, PeripheralNeuropathy –Neurological Evaluation:Percentage of patients aged 18years and older with a diagnosis ofdiabetes mellitus who had aneurological examination of theirlower extremities within 12 monthsDiabetes Mellitus: Diabetic Footand Ankle Care, Ulcer Prevention– Evaluation of Footwear:Percentage of patients aged 18years and older with a diagnosis ofdiabetes mellitus who wereevaluated for proper footwear andsizingPreventive Care and Screening:Body Mass Index (BMI) Screeningand Follow-Up Plan: Percentage ofpatients aged 18 years and olderwith a BMI documented during thecurrent encounter or during theprevious six months AND with aBMI outside of normal parameters,a follow-up plan is documentedduring the encounter or during theprevious six months of the currentencounterNormal Parameters: Age 65 yearsand older BMI 23 and 30 kg/m2;Age 18 – 64 years BMI 18.5 and 25 kg/m2Page 5 of 8

2016 Physical Therapy/Occupational Therapy Preferred Specialty Measure odNational Quality R, GPRO(Web Interface)Patient ion and Patient ion and CareCoordination2624Claims,RegistryCommunication and CareCoordinationMeasure Title: DescriptionDocumentation of CurrentMedications in the MedicalRecord: Percentage of visits forpatients aged 18 years and older forwhich the eligible professionalattests to documenting a list ofcurrent medications using allimmediate resources available onthe date of the encounter. This listmust include ALL knownprescriptions, over-the-counters,herbals, and vitamin/mineral/dietary(nutritional) supplements AND mustcontain the medications’ name,dosage, frequency and route ofadministrationPain Assessment and Follow-Up:Percentage of visits for patientsaged 18 years and older withdocumentation of a painassessment using a standardizedtool(s) on each visit ANDdocumentation of a follow-up planwhen pain is presentFalls: Risk Assessment:Percentage of patients aged 65years and older with a history offalls who had a risk assessment forfalls completed within 12 monthsFalls: Plan of Care: Percentage ofpatients aged 65 years and olderwith a history of falls who had a planof care for falls documented within12 monthsFunctional Outcome Assessment:Percentage of visits for patientsaged 18 years and older withdocumentation of a currentfunctional outcome assessmentusing a standardized functionaloutcome assessment tool on thedate of encounter ANDdocumentation of a care plan basedon identified functional outcomedeficiencies on the date of theidentified deficienciesPage 6 of 8

2016 Physical Therapy/Occupational Therapy Preferred Specialty Measure ional Quality StrategyDomainCommunication and CareCoordinationCommunication and CareCoordinationCommunication and CareCoordinationCommunication and CareCoordinationMeasure Title: DescriptionFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with KneeImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the knee in which thechange in their Risk-AdjustedFunctional Status is measuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with HipImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the hip in which the changein their Risk-Adjusted FunctionalStatus is measuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with Lower Leg, Footor Ankle Impairments: Percentageof patients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the lower leg, foot or ankle inwhich the change in their RiskAdjusted Functional Status ismeasuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with Lumbar SpineImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the lumbar spine in whichthe change in their Risk-AdjustedFunctional Status is measuredPage 7 of 8

2016 Physical Therapy/Occupational Therapy Preferred Specialty Measure gistryRegistryRegistryNational Quality StrategyDomainCommunication and CareCoordinationCommunication and CareCoordinationCommunication and CareCoordinationMeasure Title: DescriptionFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with ShoulderImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the shoulder in which thechange in their Risk-AdjustedFunctional Status is measuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with Elbow, Wrist orHand Impairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the elbow, wrist or hand inwhich the change in their RiskAdjusted Functional Status ismeasuredFunctional Deficit: Change inRisk-Adjusted Functional Statusfor Patients with Neck, Cranium,Mandible, Thoracic Spine, Ribs,or Other General OrthopedicImpairments: Percentage ofpatients aged 18 or older thatreceive treatment for a functionaldeficit secondary to a diagnosis thataffects the neck, cranium, mandible,thoracic spine, ribs, or other generalorthopedic impairment in which thechange in their Risk-AdjustedFunctional Status is measuredThis table is a resource of potential measures that may be applicable to eligible professionals providing clinical services forPhysical or Occupational Therapy. Please note that in addition to this table, a cross cutting measures list is also available forreporting at the following link:2016 Cross-Cutting Measures List01/06/2016Page 8 of 8

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