Certification, Costs
and Limitations

• 170.314(a)(1) – Computerized provider order entry
• 170.314(a)(3) – Demographics
• 170.314(a)(5) – Problem list
• 170.314(a)(7) – Medication allergy list
• 170.314(a)(9) – Electronic notes
• 170.314(a)(11) – Smoking status
• 170.314(a)(13) – Family health history
• 170.314(a)(15) – Patient-specific education resources
• 170.314(b)(2) – Transitions of care – create and transmit transition of care/referral summaries
• 170.314(b)(4) – Clinical information reconciliation
• 170.314(b)(7) – Data portability
• 170.314(c)(2) – Clinical quality measures – import and calculate
• 170.314(d)(1) – Authentication, access, control, and authorization
• 170.314(d)(3) – Audit report(s)
• 170.314(d)(5) – Automatic log-off
• 170.314(d)(7) – End-user device encryption
• 170.314(e)(1) – View, download, and transmit to a 3rd party with edge protocol testing
• 170.314(e)(3) – Ambulatory setting only – secure messaging
• 170.314(f)(2) – Transmission to immunization registries
• 170.314(g)(2) – Automated measure calculation
• 170.314(g)(4) – Quality management system
• 170.314(a)(2) – Drug-drug, drug-allergy interactions checks
• 170.314(a)(4) – Vital signs, body mass index, and growth Charts
• 170.314(a)(6) – Medication list
• 170.314(a)(8) – Clinical decision support
• 170.314(a)(10) – Drug formulary checks
• 170.314(a)(12) – Image results
• 170.314(a)(14) – Patient list creation
• 170.314(b)(1) – Transitions of care – receive, display and incorporate transition of care/referral summaries
• 170.314(b)(3) – Electronic prescribing
• 170.314(b)(5)(A) – Incorporate laboratory tests and values/results
• 170.314(c)(1) – Clinical quality measures – capture and export
• 170.314(c)(3) – Clinical quality measures – electronic submission
• 170.314(d)(2) – Auditable events and tamper-resistance
• 170.314(d)(4) – Amendments
• 170.314(d)(6) – Emergency access
• 170.314(d)(8) – Integrity
• 170.314(e)(2) – Ambulatory setting only -clinical summary
• 170.314(f)(1) – Immunization information
• 170.314(f)(3) – Transmission to public health agencies – syndromic surveillance
• 170.314(g)(3) – Safety-enhanced design

CMS2: Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan

CMS22: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

CMS50: Closing the Referral Loop: Receipt of Specialist Report

CMS52: HIV/AIDS: Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis

CMS56: Functional Status Assessment for Hip Replacement

CMS61: Preventive Care and Screening: Cholesterol – Fasting Low Density Lipoprotein (LDL-C) Test Performed

CMS62: HIV/AIDS: Medical Visit

CMS64: Preventive Care and Screening: Risk-Stratified Cholesterol -Fasting Low Density Lipoprotein (LDLC)

CMS65: Hypertension: Improvement in Blood Pressure

CMS66: Functional Status Assessment for Knee Replacement>

CMS68: Documentation of Current Medications in the Medical Record

CMS69: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

CMS74: Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists

CMS75: Children Who Have Dental Decay or Cavities

CMS77: HIV/AIDS: RNA control for Patients with HIV

CMS82: Maternal Depression Screening

CMS90: Functional Status Assessment for Complex Chronic Conditions

CMS117: Childhood Immunization Status

CMS122: Diabetes: Hemoglobin A1c Poor Control

CMS123: Diabetes: Foot Exam

CMS124: Cervical Cancer Screening

CMS125: Breast Cancer Screening

CMS126: Use of Appropriate Medications for Asthma

CMS127: Pneumonia Vaccination Status for Older Adults

CMS128: Anti-depressant Medication Management

CMS129: Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients

CMS130: Colorectal Cancer Screening

CMS131: Diabetes: Eye Exam

CMS132: Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures

CMS133: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery

CMS134: Diabetes: Urine Protein Screening

CMS135: Heart Failure (HF): AngiotensinConverting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)

CMS136: ADHD: Follow-Up Care for Children Prescribed AttentionDeficit/Hyperactivi ty Disorder (ADHD) Medication

CMS137: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

CMS138: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

CMS139: Falls: Screening for Future Fall Risk

CMS140: Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/ Progesterone Receptor (ER/PR) Positive Breast Cancer

CMS141: Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients

CMS142: Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

CMS143: Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation

CMS144: Heart Failure (HF): BetaBlocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

CMS145: Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF < 40%)

CMS146: Appropriate Testing for Children with Pharyngitis

CMS147: Preventive Care and Screening: Influenza Immunization

CMS148: Hemoglobin A1c Test for Pediatric Patients

CMS149: Dementia: Cognitive Assessment

CMS153: Chlamydia Screening for Women

CMS154: Appropriate Treatment for Children with Upper Respiratory Infection (URI)

CMS155: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

CMS156: Use of High-Risk Medications in the Elderly

CMS157: Oncology: Medical and Radiation – Pain Intensity Quantified

CMS158: Pregnant women that had HBsAg testing

CMS159: Depression Remission at Twelve Months

CMS160: Depression Utilization of the PHQ-9 Tool

CMS161: Adult Major Depressive Disorder (MDD): Suicide Risk Assessment

CMS163: Diabetes: Low Density Lipoprotein (LDL) Management

CMS164: Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

CMS165: Controlling High Blood Pressure

CMS166: Use of Imaging Studies for Low Back Pain

CMS167: Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy

CMS169: Bipolar Disorder and Major Depression: Appraisal for alcohol or chemical substance use

CMS177: Child and Adolescent Major Depressive Disorder (MDD): Suicide Risk Assessment

CMS179: ADE Prevention and Monitoring: Warfarin Time in Therapeutic Range

CMS182: Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control>

• 170.314(a)(1) – Computerized provider order entry
• 170.314(a)(3) – Demographics
• 170.314(a)(5) – Problem list
• 170.314(a)(7) – Medication allergy list
• 170.314(a)(9) – Electronic notes
• 170.314(a)(11) – Smoking status
• 170.314(a)(13) – Family health history
• 170.314(a)(15) – Patient-specific education resources
• 170.314(b)(2) – Transitions of care – create and transmit transition of care/referral summaries
• 170.314(b)(4) – Clinical information reconciliation
• 170.314(b)(7) – Data portability
• 170.314(c)(2) – Clinical quality measures – import and calculate
• 170.314(d)(1) – Authentication, access, control, and authorization
• 170.314(d)(3) – Audit report(s)
• 170.314(d)(5) – Automatic log-off
• 170.314(d)(7) – End-user device encryption
• 170.314(d)(9) – Optional – accounting of disclosures
• 170.314(e)(1) – View, download, and transmit to a 3rd party with edge protocol testing
• 170.314(e)(3) – Ambulatory setting only – secure messaging
• 170.314(f)(2) – Transmission to immunization registries
• 170.314(g)(2) – Automated measure calculation
• 170.314(g)(4) – Quality management system
• 170.314(a)(2) – Drug-drug, drug-allergy interactions checks
• 170.314(a)(4) – Vital signs, body mass index, and growth Charts
• 170.314(a)(6) – Medication list
• 170.314(a)(8) – Clinical decision support
• 170.314(a)(10) – Drug formulary checks
• 170.314(a)(12) – Image results
• 170.314(a)(14) – Patient list creation
• 170.314(b)(1) – Transitions of care – receive, display and incorporate transition of care/referral summaries
• 170.314(b)(3) – Electronic prescribing
• 170.314(b)(5)(A) – Incorporate laboratory tests and values/results
• 170.314(c)(1) – Clinical quality measures – capture and export
• 170.314(c)(3) – Clinical quality measures – electronic submission
• 170.314(d)(2) – Auditable events and tamper-resistance
• 170.314(d)(4) – Amendments
• 170.314(d)(6) – Emergency access
• 170.314(d)(8) – Integrity
• 170.314(e)(2) – Ambulatory setting only -clinical summary
• 170.314(f)(1) – Immunization information
• 170.314(f)(3) – Transmission to public health agencies – syndromic surveillance
• 170.314(g)(3) – Safety-enhanced design

‍

CMS2: Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan

CMS22: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

CMS50: Closing the Referral Loop: Receipt of Specialist Report

CMS52: HIV/AIDS: Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis

CMS56: Functional Status Assessment for Hip Replacement

CMS61: Preventive Care and Screening: Cholesterol – Fasting Low Density Lipoprotein (LDL-C) Test Performed

CMS62: HIV/AIDS: Medical Visit

CMS64: Preventive Care and Screening: Risk-Stratified Cholesterol -Fasting Low Density Lipoprotein (LDLC)

CMS65: Hypertension: Improvement in Blood Pressure

CMS66: Functional Status Assessment for Knee Replacement>

CMS68: Documentation of Current Medications in the Medical Record

CMS69: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

CMS74: Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists

CMS75: Children Who Have Dental Decay or Cavities

CMS77: HIV/AIDS: RNA control for Patients with HIV

CMS82: Maternal Depression Screening

CMS90: Functional Status Assessment for Complex Chronic Conditions

CMS117: Childhood Immunization Status

CMS122: Diabetes: Hemoglobin A1c Poor Control

CMS123: Diabetes: Foot Exam

CMS124: Cervical Cancer Screening

CMS125: Breast Cancer Screening

CMS126: Use of Appropriate Medications for Asthma

CMS127: Pneumonia Vaccination Status for Older Adults

CMS128: Anti-depressant Medication Management

CMS129: Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients

CMS130: Colorectal Cancer Screening

CMS131: Diabetes: Eye Exam

CMS132: Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures

CMS133: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery

CMS134: Diabetes: Urine Protein Screening

CMS135: Heart Failure (HF): AngiotensinConverting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)

CMS136: ADHD: Follow-Up Care for Children Prescribed AttentionDeficit/Hyperactivi ty Disorder (ADHD) Medication

CMS137: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

CMS138: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

CMS139: Falls: Screening for Future Fall Risk

CMS140: Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/ Progesterone Receptor (ER/PR) Positive Breast Cancer

CMS141: Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients

CMS142: Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

CMS143: Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation

CMS144: Heart Failure (HF): BetaBlocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

CMS145: Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF < 40%)

CMS146: Appropriate Testing for Children with Pharyngitis

CMS147: Preventive Care and Screening: Influenza Immunization

CMS148: Hemoglobin A1c Test for Pediatric Patients

CMS149: Dementia: Cognitive Assessment

CMS153: Chlamydia Screening for Women

CMS154: Appropriate Treatment for Children with Upper Respiratory Infection (URI)

CMS155: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

CMS156: Use of High-Risk Medications in the Elderly

CMS157: Oncology: Medical and Radiation – Pain Intensity Quantified

CMS158: Pregnant women that had HBsAg testing

CMS159: Depression Remission at Twelve Months

CMS160: Depression Utilization of the PHQ-9 Tool

CMS161: Adult Major Depressive Disorder (MDD): Suicide Risk Assessment

CMS163: Diabetes: Low Density Lipoprotein (LDL) Management

CMS164: Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

CMS165: Controlling High Blood Pressure

CMS166: Use of Imaging Studies for Low Back Pain

CMS167: Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy

CMS169: Bipolar Disorder and Major Depression: Appraisal for alcohol or chemical substance use

CMS177: Child and Adolescent Major Depressive Disorder (MDD): Suicide Risk Assessment

CMS179: ADE Prevention and Monitoring: Warfarin Time in Therapeutic Range

CMS182: Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control

‍

• 170.314(a)(1) – Computerized provider order entry
• 170.314(a)(3) – Demographics
• 170.314(a)(5) – Problem list
• 170.314(a)(7) – Medication allergy list
• 170.314(a)(9) – Electronic notes
• 170.314(a)(11) – Smoking status
• 170.314(a)(13) – Family health history
• 170.314(a)(15) – Patient-specific education resources
• 170.314(b)(2) – Transitions of care – create and transmit transition of care/referral summaries
• 170.314(b)(4) – Clinical information reconciliation
• 170.314(b)(7) – Data portability
• 170.314(c)(2) – Clinical quality measures – import and calculate
• 170.314(d)(1) – Authentication, access, control, and authorization
• 170.314(d)(3) – Audit report(s)
• 170.314(d)(5) – Automatic log-off
• 170.314(d)(7) – End-user device encryption
• 170.314(d)(9) – Optional – accounting of disclosures
• 170.314(e)(2) – Ambulatory setting only – clinical summary
• 170.314(f)(1) – Immunization information
• 170.314(f)(3) – Transmission to public health agencies – syndromic surveillance
• 170.314(g)(3) – Safety-enhanced design
• 170.314(a)(2) – Drug-drug, drug-allergy interactions checks
• 170.314(a)(4) – Vital signs, body mass index, and growth Charts
• 170.314(a)(6) – Medication list
• 170.314(a)(8) – Clinical decision support
• 170.314(a)(10) – Drug formulary checks
• 170.314(a)(12) – Image results
• 170.314(a)(14) – Patient list creation
• 170.314(b)(1) – Transitions of care – receive, display and incorporate transition of care/referral summaries
• 170.314(b)(3) – Electronic prescribing
• 170.314(b)(5)(A) – Incorporate laboratory tests and values/results
• 170.314(c)(1) – Clinical quality measures – capture and export
• 170.314(c)(3) – Clinical quality measures – electronic submission
• 170.314(d)(2) – Auditable events and tamper-resistance
• 170.314(d)(4) – Amendments
• 170.314(d)(6) – Emergency access
• 170.314(d)(8) – Integrity
• 170.314(e)(1) – View, download, and transmit to a 3rd party with edge protocol testing
• 170.314(e)(3) – Ambulatory setting only – secure messaging
• 170.314(f)(2) – Transmission to immunization registries
• 170.314(g)(2) – Automated measure calculation
• 170.314(g)(4) – Quality management system

‍

CMS2: Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan

CMS22: Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

CMS50: Closing the Referral Loop: Receipt of Specialist Report

CMS52: HIV/AIDS: Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis

CMS56: Functional Status Assessment for Hip Replacement

CMS61: Preventive Care and Screening: Cholesterol – Fasting Low Density Lipoprotein (LDL-C) Test Performed

CMS62: HIV/AIDS: Medical Visit

CMS64: Preventive Care and Screening: Risk-Stratified Cholesterol -Fasting Low Density Lipoprotein (LDLC)

CMS65: Hypertension: Improvement in Blood Pressure

CMS66: Functional Status Assessment for Knee Replacement>

CMS68: Documentation of Current Medications in the Medical Record

CMS69: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

CMS74: Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists

CMS75: Children Who Have Dental Decay or Cavities

CMS77: HIV/AIDS: RNA control for Patients with HIV

CMS82: Maternal Depression Screening

CMS90: Functional Status Assessment for Complex Chronic Conditions

CMS117: Childhood Immunization Status

CMS122: Diabetes: Hemoglobin A1c Poor Control

CMS123: Diabetes: Foot Exam

CMS124: Cervical Cancer Screening

CMS125: Breast Cancer Screening

CMS126: Use of Appropriate Medications for Asthma

CMS127: Pneumonia Vaccination Status for Older Adults

CMS128: Anti-depressant Medication Management

CMS129: Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients

CMS130: Colorectal Cancer Screening

CMS131: Diabetes: Eye Exam

CMS132: Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures

CMS133: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery

CMS134: Diabetes: Urine Protein Screening

CMS135: Heart Failure (HF): AngiotensinConverting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)

CMS136: ADHD: Follow-Up Care for Children Prescribed AttentionDeficit/Hyperactivi ty Disorder (ADHD) Medication

CMS137: Initiation and Engagement of Alcohol and Other Drug Dependence Treatment

CMS138: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

CMS139: Falls: Screening for Future Fall Risk

CMS140: Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/ Progesterone Receptor (ER/PR) Positive Breast Cancer

CMS141: Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients

CMS142: Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care

CMS143: Primary Open Angle Glaucoma (POAG): Optic Nerve Evaluation

CMS144: Heart Failure (HF): BetaBlocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

CMS145: Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF < 40%)

CMS146: Appropriate Testing for Children with Pharyngitis

CMS147: Preventive Care and Screening: Influenza Immunization

CMS148: Hemoglobin A1c Test for Pediatric Patients

CMS149: Dementia: Cognitive Assessment

CMS153: Chlamydia Screening for Women

CMS154: Appropriate Treatment for Children with Upper Respiratory Infection (URI)

CMS155: Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents

CMS156: Use of High-Risk Medications in the Elderly

CMS157: Oncology: Medical and Radiation – Pain Intensity Quantified

CMS158: Pregnant women that had HBsAg testing

CMS159: Depression Remission at Twelve Months

CMS160: Depression Utilization of the PHQ-9 Tool

CMS161: Adult Major Depressive Disorder (MDD): Suicide Risk Assessment

CMS163: Diabetes: Low Density Lipoprotein (LDL) Management

CMS164: Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antithrombotic

CMS165: Controlling High Blood Pressure

CMS166: Use of Imaging Studies for Low Back Pain

CMS167: Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy

CMS169: Bipolar Disorder and Major Depression: Appraisal for alcohol or chemical substance use

CMS177: Child and Adolescent Major Depressive Disorder (MDD): Suicide Risk Assessment

CMS179: ADE Prevention and Monitoring: Warfarin Time in Therapeutic Range

CMS182: Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control>

‍