2023 # MBHR10 Symptom Improvement in adults with ADHD

Measure Title: Symptom Improvement in adults with ADHD

Description: The percentage of adult patients (18 years of age or older) with a diagnosis of ADHD who show a reduction in symptoms of 25% on the Adult ADHD Self-Report Scale (ASRS-v1.1)- 18 item self-report scale of ADHD symptoms within 2 to 10 months after initially reporting significant symptoms.  There are two aspects to this measure.   The first is the assessment of the use of the ASRS v.1. during the denominator identification period (Criteria 1 also referred to as Time 1) and the second is the assessment of improvement in the ASRS v.1.1 from the first administration to the second administration of the ASRS v.1.1 (Criteria 2 also referred to as Time 2).

To see additional details, please view the workflow diagram for this measure: View diagram

This measure relies on the Adult ADHD Self-Report Scale (ASRS-v1.1) assessment tool, which can be found here.

Denominator: 

Denominator (Submission Criteria 1):

All patients aged 18 years of age or older receiving a psychiatric or behavioral intake visit and a diagnosis of  ADHD during the measurement period.

Denominator Criteria (Eligible cases):

Patients aged 18 years and older

AND 

Diagnosis  for ADHD (ICD-10-CM): all ADHD diagnostic codes:

• F90 Attention-deficit hyperactivity disorders

• F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type

• F90.1 Attention-deficit hyperactivity disorder, predominantly hyperactive type

• F90.2 Attention-deficit hyperactivity disorder, combined type

• F90.8 Attention-deficit hyperactivity disorder, other type

• F90.9 Attention-deficit hyperactivity disorder, unspecified type

AND

Patient encounter during the performance period (CPT): 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

Denominator (Submission Criteria 2):

All patients aged 18 years of age or older receiving a psychiatric or behavioral intake visit with a clinically significant baseline ASRS score of 18 or above for ADHD Inattentive (INN) or a score of 18 or above for ADHD Hyperactive (HYP) during the measurement period.  If either of these scores are 18 or above the total score will also be reported.

Denominator Criteria (Eligible cases):

Patients aged 18 years or older

AND

Diagnosis for ADHD (ICD-10-CM): all ADHD diagnostic codes:

• F90 Attention-deficit hyperactivity disorders

• F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type

• F90.1 Attention-deficit hyperactivity disorder, predominantly hyperactive type

• F90.2 Attention-deficit hyperactivity disorder, combined type

• F90.8 Attention-deficit hyperactivity disorder, other type

• F90.9 Attention-deficit hyperactivity disorder, unspecified type

AND

Patient encounter during the performance period (CPT): 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

ASRS score of 18 or above for ADHD INN or ADHD HYP or a total ADHD score of 36 or above

Numerator: 

Numerator (Submission Criteria 1)

Patients who were administered the ASRS v1.1 checklist

Numerator (Submission Criteria 2)

Patients who demonstrated a positive improvement of  .25 (25%) or more points

Denominator Exclusions: Submission Criteria 1: 
·         Patients who die OR
·         Are enrolled in hospice in the measurement year OR
·         Are unable to complete the measure 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 measure 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 Care: Clinician Office/Clinic; Ambulatory Care: Hospital; Hospital Outpatient; Long Term Care; Nursing Home; Outpatient Services; Rehabilitation Facility

Telehealth, if applicable
Yes

Number of performance rates required for measures
2

Traditional vs. inverse measure
Traditional

Proportional, continuous variable, and/or ratio measure indicator
Proportional

Risk adjustment, if applicable
No

Submission pathway 
Traditional MIPS