Measure 226

Q. Is this measure reportable via claims?

A. Yes.

Q. Are patient encounters conducted via telehealth allowable?

A. Yes, encounters coded with GQ, GT, 95, POS 02, or POS 10 modifiers are allowable.

Q. The measure says to report once per performance period. Is the performance period a year?

A. Yes, for Quality Payment Program (QPP) year 2025, the 12-month performance period would be from 1/1/2025-12/31/2025.

Q. The measure states that two patient encounters are required. What does this mean?

A. The denominator criteria (or the eligible patient population) is all patients 12 and older who had one preventive encounter OR two patient encounters during the measurement period. For most dermatologists this will fall under the 2 patient encounters criteria since CPT codes: 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, etc. are listed there.

Because this measure has a 12-month performance period, all patients who have 2 encounters between 1/1/2025-12/31/2025 are eligible for this measure.

Q. Do I have to screen the patient every year?

A. Yes, the patient should be screened at least once every year.

Q. What if screening is completed and the patient is identified as a tobacco user, but then the patient refuses to receive the tobacco cessation intervention. Would the performance not be met for criteria 2?

A. If a patient screens as a tobacco user, then a cessation intervention must be implemented, or the measure will count against you. Cessation interventions include brief counseling (3 minutes or less) or pharmacotherapy.

Q. Does a patient need to meet all criteria (1, 2, & 3) in order to meet performance for this measure?

A. Yes. A patient needs to be identified as either a tobacco non-user OR a tobacco user who then receives a cessation intervention in order to meet the measure requirements.

Q. What qualifies as providing a patient with a tobacco cessation intervention?

A. Interventions include brief counseling (3 minutes or less), which can be minimal and intensive advice/counseling interventions conducted both in person and over the phone and/or pharmacotherapy. Written self-help materials (e.g., brochures, pamphlets) and complementary/ alternative therapies do not qualify.

Q. If we screen the patient and they respond they do not use tobacco, and therefore we do not provide any cessation information, will that be accepted for these measures?

A. This qualifies as the performance met. Cessation information would not be provided because the patient is not a tobacco user.

Q. I completed the first criteria of the measure but criteria 2 and 3 seem the same. Reporting criteria 2 is for all patients who were identified as tobacco users and who received tobacco cessation intervention. Reporting criteria 3 is for all patients who were screened for tobacco use and, if identified as a tobacco user, received tobacco cessation intervention OR the patient identified as a tobacco non-user.

A. The criteria can seem similar, but criteria 3 is used to compare performance to prior published versions of this measure, which was only criteria 3. The measure has since been revised (the current version) into separate criteria to better identify gaps in performance.

Q. What is the difference between smoking and the use of tobacco products?

A. All tobacco use should be assessed, (e.g., cigarettes, cigars (including cigarillos and little cigars), dissolvables, hookah tobacco, nicotine gels, pipe tobacco, roll-your-own tobacco, smokeless tobacco products (including dip, snuff, snus, and chewing tobacco), vapes, electronic cigarettes (e-cigarettes), hookah pens, and other electronic nicotine delivery systems).