A health and behavior assessment/intervention.An observation visit (observation value set) 99217–99220.NOTE: **T1015 HCPCS code which identifies an all-inclusive clinic visit for services rendered at a Federally Qualified Health Center (FQHC).The following code combinations identify follow-up visits: Narcolepsy in conditions classified elsewhere without cataplexy.Narcolepsy in conditions classified elsewhere with cataplexy.Optional Exclusions: Members with a diagnosis of narcolepsy any time during their history through December 31 or the measurement year. Patients who had an acute inpatient encounter for a mental, behavioral or neurodevelopmental disorder during the 30 days after the IPSD.Applies to only Rate 1 – Initiation phase. Patients who filled an ADHD prescription 120 days (4 months) prior to the IPSD (Index Prescription Start Date).Only one of the two visits (during days 31–300) may be an e-visit or virtual check-in.Consider prescribing an initial two-week supply and follow-up prescriptions to a 30-day supply to ensure patient follow-up.Consider scheduling follow-up visit within 14 to 21 days of each prescription.Schedule a 30-day, 60-day and 180-day follow-up visit from the initial visit before member leaves office.Schedule follow-up visits to occur before the refill is given.When prescribing a new ADHD medication for a patient:.Timing of scheduled visits is key based on the prescription day supply to evaluate medication effectiveness, any adverse effects and to monitor the patient’s progress. Age Clarification: 6 years as of March 1 of the year prior to the measurement year to 12 years as of the last calendar day of February of the measurement year.Continuation and Maintenance (C&M) Phase: percentage of members 6-12 years of age with an ambulatory prescription dispensed for ADHD medication, who remained on the medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase.Initiation Phase: percentage of members 6-12 years of age as of the IPSD (Index Prescription Start Date) with an ambulatory prescription dispensed for ADHD medication, who had one follow-up visit with practitioner with prescribing authority during the 30-day Initiation Phase.One visit is required within 30 days of when the first ADHD medication was dispensed. Measure evaluates the percentage of members 6-12 years of age with newly prescribed attention-deficit/hyperactivity disorder (ADHD) medication who had at least three follow up care visits within a 10-month period.
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