URSA-MSSP-CQM-BCS-PR: Breast Cancer Screening CQM (Q112 CQM PR)

  • Published on Aug 21, 2025
  • 2 minute(s) read
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Measure Description

Among women 40 to 74 years of age with a prior qualifying visit in the last 12 months and data completeness for the prior 12 months, the percentage with a mammogram to screen for breast cancer in the prior 27 months.

Metadata

  • Measure Type: Rate Measure
  • Temporal Structure: Entity
  • Component Class: Normal-Form
  • Denominator Case Field: Patient ID
  • Target Direction: Up

Denominator Description

Women 40-74 years of age with a prior qualifying visit in the last 12 months and data completeness.

Numerator Description

Patients with qualifying denominator patients with one or more mammograms in the 27 months prior to the snapshot date.

Published Fields

  • Data Model Keys

    • Measure ID
    • Patient ID

  • Operations Support Fields

    • Affiliated Program Entity ID
    • Affiliated Program Entity Provider ID
    • Primary Plan Attributee Provider Contract ID
    • Program Entity Operational ID
    • Program Operational ID
    • Patient Operational ID
    • Is Patient Affiliated to a Program Entity

  • Denominator Fields

    • Is Denominator Event Criterion Met
    • Qualifying Denominator Encounter Date
    • Qualifying Denominator Encounter Provider ID
    • Qualifying Denominator Encounter Provider Description
    • Is Data Completeness Continuous Membership Criterion Met
    • Is Any Required Exclusion
    • Is Required Exclusion for Bilateral Mastectomy
    • Is Required Exclusion for Hospice
    • Is Required Exclusion for 66+ with Institutional Special Needs Plan
    • Is Required Exclusion for 66+ with Frailty and Dementia Medications
    • Is Required Exclusion for 66+ with Frailty and Advanced Illness
    • Is Eligible Population
    • Required Exclusions Description
    • Affiliated Program Entity Provider NPI
    • Affiliated Program Entity Provider Description

  • Numerator Fields

    • Numerator Component Contribution
    • Numerator Category Description
    • Numerator Document ID
    • Numerator Document Effective Date
    • Numerator HCPCS Code
    • Numerator HCPCS Description
    • Numerator Source ID
    • Is Numerator Qualifying Using Standard End-of-Year Timing
    • Numerator Component Contribution Using Standard End-of-Year Timing

  • Patient Fields

    • Patient Age at Beginning of Performance Period
    • Patient Date of Birth
    • Patient State Abbreviation
    • Patient ZIP Code 5-Digit
    • Is Patient Sex Female
    • Is Patient Sex Male

  • Insurance Fields

    • Primary Payor ID
    • Primary Plan ID
    • Primary Plan Attributee Provider ID
    • Primary Plan Attributee Provider Description
    • Member MBI
    • Primary Payor Description
    • Primary Plan Description
    • Primary Plan Financial Class Description

  • Date Fields

    • Snapshot Date -- The date, evaluated at 00:00:00 AM, giving the moment the state of the world will be set to for the purposes of an analysis. The snapshot date does not represent the freshness of the data, or the date in real time at which an analysis was executed.
    • Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
    • Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)

  • Measure Fields

    • Denominator