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What are the Requirements/ 
Clinical Quality Measures
• Clinical Quality Measures –Core Set
NQF Measure Number & PQRI 
Implementation Number
Clinical Quality Measure Title
NQF 0013
Hypertension: Blood Pressure 
NQF 0028
Preventive Careand Screening Measure 
Pair: a) Tobacco Use Assessment, b) 
Tobacco Cessation Intervention
NQF 0421
PQRI 128
Adult Weight Screeningand Follow-up
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What are the Requirements/ 
Clinical Quality Measures
• Clinical Quality Measures –Alternate 
Core Set
NQF Measure Number & PQRI 
Implementation Number
Clinical Quality Measure Title
NQF 0024
Weight Assessment and Counseling for 
Children and Adolescents
PQRI 110
Preventive Care and Screening: 
InfluenzaImmunization for Patients50 
Years Old or Older
NQF 0038
Childhood Immunization Status
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What are the Requirements/ 
Clinical Quality Measures
• Additional set CQM–must complete 3 of 38
1. Diabetes: Hemoglobin A1c Poor Control 
2. Diabetes: Low Density Lipoprotein (LDL) Management 
and Control 
3. Diabetes: Blood Pressure Management
4. Heart Failure (HF): Angiotensin-Converting Enzyme 
(ACE) Inhibitor or AngiotensinReceptor Blocker (ARB) 
Therapy for Left Ventricular Systolic Dysfunction (LVSD) 
5. Coronary Artery Disease (CAD): Beta-Blocker Therapy 
for CAD Patients with Prior Myocardial Infarction (MI)
6. Pneumonia Vaccination Status for Older Adults
7. Breast Cancer Screening
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What are the Requirements/ 
Clinical Quality Measures
• Additional set CQM–must complete 3 of 38
8. Colorectal Cancer Screening
9. Coronary Artery Disease (CAD): Oral AntiplateletTherapy 
Prescribed for Patients with CAD
10.Heart Failure (HF): Beta-Blocker Therapy for Left 
Ventricular Systolic Dysfunction (LVSD)
11.Anti-depressant medication management: (a) Effective 
Acute Phase Treatment, (b)Effective Continuation Phase 
12.Primary Open Angle Glaucoma (POAG): Optic Nerve 
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What are the Requirements/ 
Clinical Quality Measures
• Additional set CQM–must complete 3 of 38
13.Diabetic Retinopathy: Documentation of Presence or 
Absence of Macular Edema and Level of Severity of 
14.Diabetic Retinopathy: Communication with the Physician 
Managing Ongoing Diabetes Care
15.Asthma Pharmacologic Therapy 
16.Asthma Assessment
17.Appropriate Testing for Children with Pharyngitis
18.Oncology Breast Cancer: Hormonal Therapy for Stage 
IC-IIIC Estrogen Receptor/Progesterone Receptor 
(ER/PR) Positive Breast Cancer 
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What are the Requirements/ 
Clinical Quality Measures
• Additional set CQM–must complete 3 of 38
19.Oncology Colon Cancer: Chemotherapy for Stage III 
Colon Cancer Patients 
20.Prostate Cancer: Avoidance of Overuse of Bone 
Scan for Staging Low Risk Prostate Cancer Patients
21.Smoking and Tobacco Use Cessation, Medical 
Assistance: a) Advising Smokers and Tobacco Users 
to Quit, b) Discussing Smoking and Tobacco Use 
Cessation Medications, c) Discussing Smoking and 
Tobacco Use Cessation Strategies 
22.Diabetes: Eye Exam
23.Diabetes: Urine Screening
What are the Requirements/ 
Clinical Quality Measures
• Additional set CQM–must complete 3 of 38
24.Diabetes: Foot Exam
25.Coronary Artery Disease (CAD): Drug Therapy for 
Lowering LDL-Cholesterol
26.Heart Failure (HF): WarfarinTherapy Patients with 
27.Ischemic Vascular Disease (IVD): Blood Pressure 
28.Ischemic Vascular Disease (IVD): Use of Aspirin or 
Another Antithrombotic 
What are the Requirements/ 
Clinical Quality Measures
• Additional set CQM–must complete 3 of 38
29.Initiation and Engagement of Alcohol and Other 
Drug Dependence Treatment: a) Initiation, b) 
30.Prenatal Care: Screening for Human 
Immunodeficiency Virus (HIV)
31.Prenatal Care: Anti-D Immune Globulin
32.Controlling High Blood Pressure 
33.Cervical Cancer Screening
34.Chlamydia Screening for Women 
What are the Requirements/ 
Clinical Quality Measures
• Additional set CQM–must complete 3 of 38
35.Use of Appropriate Medications for Asthma 
36.Low Back Pain: Use of Imaging Studies 
37.Ischemic Vascular Disease (IVD): Complete Lipid 
Panel and LDL Control 
38.Diabetes: Hemoglobin A1c Control (<8.0%)
• Clinical Quality Measures align with Physicians 
Clinical Quality reporting (PQRI)
• Alignment between 4 HITECH CQM and the 
CHIPRA  initial core set that providers report to 
What You Need to Participate
• All providers must:
• Register via the EHR Incentive Program website
• Be enrolled in Medicare FFS, MA, or Medicaid (FFS 
or managed care)
• Have a National Provider Identifier (NPI)
• Use certified EHR technology 
• Medicaid providers may adopt, implement, or upgrade in their 
first year
• All Medicare providers and Medicaid eligible 
hospitals must be enrolled in PECOS
• http://www.cms.gov/EHRIncentivePrograms
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