2023 # MBHR13 Social Role Functioning Assessment utilizing PROMIS Adult Ability to Participate in Social Roles and Activities

Measure Title: Social Role Functioning Assessment utilizing PROMIS Adult Ability to Participate in Social Roles and Activities

Description: The percentage of adult patients (18 years of age or older) who report concerns related to their psychosocial function and who have completed a standardized assessment utilizing the PROMIS Adult Ability to Participate in Social Roles and Activities during measurement period.

This measure relies on the PROMIS Ability to Participate in Social Roles and Activities assessment tool, which can be found here. 

Denominator: 

Patients aged ≥ 18 years
AND
Diagnosis for mood disorders (ICD-10-CM): F31.0, F31.1, F31.2, F31.3, F31.4, F31.5, F31.6, F31.7, F31.8, F31.9, F32.0, F32.1, F32.2, F32.3, F32.4, F32.5, F32.8, F32.9, F33.0, F33.1, F33.2, F33.3, F33.40, F33.41, F33.42, F33.8, F33.9, F34.0, F34.1, F34.8, F34.9
OR
Diagnosis for anxiety and/or trauma disorders: F40.1 Social phobias; F40.10 Social phobia, unspecified; F40.11 Social phobia, generalized; F41.0 Panic disorder without agoraphobia; F41.1 Generalized anxiety disorder; F41.3 other mixed anxiety disorders; F41.8 other specified anxiety disorders; F41.9 anxiety disorder unspecified; F43.1 Post-traumatic stress disorder (PTSD); F43.10 Post-traumatic stress disorder, unspecified; F43.11 Post-traumatic stress disorder, acute; F43.12 Post-traumatic stress disorder, chronic

OR

Diagnosis for psychosis disorders:  F20.0 – Paranoid schizophrenia 

F20.1 – Disorganized schizophrenia 

F20.2 – Catatonic schizophrenia 

F20.3 – Undifferentiated schizophrenia 

F20.5 – Residual schizophrenia 

F20.81 – Schizophreniform disorder 

F20.89 – Other schizophrenia 

F20.9 – Schizophrenia, unspecified 

F23 – Brief psychotic disorder 

F25.0 – Schizoaffective disorder, bipolar type 

F25.1 – Schizoaffective disorder, depressive type 

F25.8 – Other schizoaffective disorders 

F25.9 – Schizoaffective disorder, unspecified 

F28 – Other psychotic disorder not due to a substance or known physiological condition 

AND

Patient encounter during the denominator identification period (CPT or HCPCS):
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

Numerator: Adult patients (18 years of age or older) included in the denominator who have at least one completed administration of the PROMIS Adult Ability to Participate in Social Roles and Activities short form or computer adaptive test during a four month measurement period.  If the T-score is equal to or less than 40, this suggests a probable difficulty with social role function and ability to effectively participate in one’s usual role, which requires documentation of an appropriate follow-up plan such as further evaluation or referral to treatment.

Denominator Exclusions: 

• Patients who die OR
  • Are enrolled in hospice in the measurement year OR
  • Are unable to complete the PROMIS adult Ability to Participate in Social Roles and Activities 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: None

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