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

Percentage of patients aged 12 years and older screened for depression on the date of the encounter or up to 14 days prior to the date of the encounter using an age-appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the eligible encounter.

Date Reviewed: September 28, 2022
Do Not Support: Uncertain Validity
    Group/Practice Individual Clinician

Measure Info

MIPS 134 CMIT ID 672
Measure Type
Process
Measure Steward
Centers for Medicare and Medicaid Services
Clinical Topic Area
Depression
Care Setting
Outpatient
Data Source
Claims
Electronic Health Records
Registry

Depression is one of the leading causes of disability and the meaningful clinical impact of screening for depression is high. Routine screening for depression can increase the detection and treatment of depression. Performance on this performance measure is high; however, it is more reflective of the accountability program (MIPS) rather than the performance measure itself, as there is underuse in depression screening. The performance measure does not have an option to exclude patients who do not need a follow-up based on clinical judgment. The numerator should be expanded to include a time frame for the referral and potential follow-up plan and should also allow physicians to get credit for any patient screening throughout the year. The addition of a look-back period would help to catch cases that may be overlooked. Finally, it is a burdensome process to document the follow-up process without the use of an electronic health record (EHR). Many facilities use internal referrals to integrated behavioral specialists, which is not necessarily built into the facility code set and requires extensive chart review to review the follow-up plan.