Measure Title: Sleep Quality Sleep Response at 3-months
Description: Percentage of patients 18 years and older who reported sleep quality concerns (e.g., insomnia) with documentation of a standardized tool AND demonstrated a response to treatment at three months (+/- 60 days) after index visit.
This measure relies on the Insomnia Severity Index assessment tool, which can be foundhere.
Denominator:
Patients aged >= 18 years of age
AND
Patient Encounter CPT codes:
0362T, 0373T, 90785, 90791, 90792, 90832,90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90875, 90876, 96110, 96112, 96113, 96116, 96121, 96127, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, 96146, 96156, 96158, 96159, 96164, 96165, 96167, 96170, 96171, 96178, 97129, 97130, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 98966, 98967, 98968, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215,99354, 99355, 99406, 99407, 99408, 99409, 99446, 99447, 99448, 99449, 99484, 99492, 99493, 99494, G2011, G2061, G2062, G2063, G0396, G0397, G0402, G0438, G0439
AND
Index Event Date: Initial (Index) Insomnia Severity Index (ISI) score of 15 or higher
AND
Follow Up Event Date: A Follow Up Insomnia Severity Index (ISI) score
Numerator: Patients 18 years and older who reported sleep quality concerns (e.g., insomnia) and an initial (index) Insomnia Severity Index (ISI) score of 15 or higher and reduction of 5 points or greater from the index score, three months (+/- 60 days) after index date.
Denominator Exclusions:
- Patients who die OR
• Are enrolled in hospice in the measurement year OR
• Are unable to complete the Insomnia Severity Index (ISI) at follow-up due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, AND a suitable recorder (e.g., advocate) is not available
Denominator Exceptions:
- Patient refused to complete the Insomnia Severity Index (ISI) at follow-up OR
- Ongoing care not indicated (e.g., referred to another provider or facility, consultation only) OR
- Patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) OR
- Medical reasons (e.g., scheduled for surgery or hospitalized)
National Quality Forum (NQF) number, if applicable
N/A
Care setting(s)
Ambulatory; Ambulatory Care: Clinician Office/Clinic; Ambulatory Care: Hospital; Home Care; Hospital; Hospital Inpatient; Hospital Outpatient; Long Term Care; Nursing Home; Outpatient Services; Rehabilitation Facility; Rehabilitation Facility: Inpatient
Telehealth, if applicable
Yes
Number of performance rates required for measures
1
Traditional vs. inverse measure
Traditional
Proportional, continuous variable, and/or ratio measure indicator
Proportional
Risk adjustment, if applicable
No
Submission pathway
Traditional MIPS