CMS 136 - Follow-Up Care for Children Prescribed ADHD Medication (ADD)

CMS136v6 (2017)

CMS136v7 (2018)

CMS136v8 (2019)

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.

  • Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase.
  • 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 Patient Population:  

Initial Population 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.

Initial Population 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 Index Prescription Start Date (IPSD), and who had a visit during the measurement period.

Denominator:  Equals Initial Population

Numerator

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.

Inverse Measure:  No

Clinical Instructions

Track children ages 6-12 that have been newly dispensed a medication for ADHD and ensure they receive appropriate follow-up care.

  • Provide a follow-up with children prescribed ADHD medication during the 30-Day Initiation Phase
  • For children remaining on the medication for 7+ months, provide two additional follow-up visits and ensure these are completed within 9 months of the Initiation Phase ending.

Evidence

Name Value Set
Diagnosis 2.16.840.1.113883.3.464.1003.114.12.1011
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1054
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1039
Encounter, Performed 2.16.840.1.113883.3.666.5.307
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1016
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1002
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1060
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1008
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1024
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1027
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1026
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1022
Encounter, Performed 2.16.840.1.113883.3.526.3.1492
Encounter, Performed 2.16.840.1.113883.3.526.3.1496
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1055
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1031
Encounter, Performed 2.16.840.1.113883.3.464.1003.101.12.1053
Intervention, Order 2.16.840.1.113762.1.4.1108.15
Intervention, Performed 2.16.840.1.113762.1.4.1108.15
Medication, Active 2.16.840.1.113883.3.464.1003.196.12.1171
Medication, Dispensed 2.16.840.1.113883.3.464.1003.196.12.1171
Patient Characteristic Ethnicity 2.16.840.1.114222.4.11.837
Patient Characteristic Payer 2.16.840.1.114222.4.11.3591
Patient Characteristic Race 2.16.840.1.114222.4.11.836
Patient Characteristic Sex 2.16.840.1.113762.1.4.1

Source(s)

Medical Codify

WebChart Documentation
Last Build: Wed, 08 Sep 2021 00:25:58 EDT Legacy Documentation