Chemotherapy Measure (OP-35)

The Admissions and ED Visits for Patients Receiving Outpatient Chemotherapy measure provides facilities with information to improve the quality of care delivered for patients undergoing outpatient chemotherapy treatment. The measure calculates two mutually exclusive outcomes:

  1. One or more inpatient admissions for anemia, dehydration, diarrhea, emesis, fever, nausea, neutropenia, pain, pneumonia, or sepsis within 30 days of chemotherapy treatment.
  2. One or more emergency department (ED) visits for any of the same 10 diagnoses within 30 days of chemotherapy treatment.

For more information on the measure, refer to the Measure Methodology page and Frequently Asked Questions document. For the measure updates and specification report and additional information, refer to the Resources page. For information on previous years’ resources, refer to the Archived Resources page.

For Calendar Year (CY) 2020 Payment Determination

The Centers for Medicare and Medicaid Services (CMS) plans to begin public reporting results for the measure in the Hospital Outpatient Quality Reporting (OQR) Program on Hospital Compare in January 2020. These results will be used for CY 2020 payment determination and will be calculated based on eligible patients receiving chemotherapy treatments during CY 2018.

Prior to public reporting of the measure, CMS plans to make available via the QualityNet Secure Portal two different types of reports to facilities:

  • Two Claims Detail Reports (CDRs)
    To be released in September 2018 (with data on eligible patients receiving chemotherapy treatments from January 1 – May 31, 2018) and March 2019 (with data on eligible patients receiving chemotherapy treatments from January 1 – November 30, 2018)
  • One Facility-Specific Report (FSR)
    To be released in October 2019 and based on data from CY 2018.

For more information on the CDRs and FSRs, refer to the Reports page.

Questions and Comments

Please submit questions about the outpatient Chemotherapy measure to the Outpatient Question and Answer tool. To ensure proper handling of inquiries, please reference the hospital’s CMS Certification Number (CCN). Do NOT email your CDR or FSR nor submit patient-identifiable information (e.g., Date of Birth, Social Security Number, Health Insurance Claim Number, dates, procedure codes) to this address. Sending screenshots and/or describing a patient listed in your FSR is considered Protected Health Information (PHI).

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