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Stage 1 Menu Measure 9

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Measure at a Glance

Type: task to be performed


Duration: completed any time during the reporting period’s year, so long that the date is on or before the last day of the reporting period

Objective: Capability to submit electronic data to immunization registries or immunization information systems and actual submission except where prohibited and according to applicable law and practice
Measure: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submissions if the test is successful (unless none of the immunization registries to which the EP submits such information has the capacity to receive the information electronically)
Exclusion: An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically

CMS Technical Specification

TennCare Notes

Eligible professionals (EPs) are required to accomplish one of the two public health menu measures: Measure 9 or Measure 10. As no public health agency in Tennessee has the capacity to receive syndromic surveillance data from EPs in the standards mandated (Menu Measure 10), EPs should attest to this measure, Menu Measure 9.

To review the relevant information and contact the registry regarding testing, please see the immunization registry fact sheet from the TN Department of Health (TDOH), as well as TDOH’s meaningful use website for public health measures.

As you review these materials and correspond with TDOH, please note a HL7 test message is required for every physical site at which the EP practices (FAQ 10979), no protected health information should be tested, and TDOH will require the following information:

  1. Facility Name:
  2. Address:
  3. Phone:
  4. Point of contact name:
  5. Point of contact email:
  6. NPI#
  7. EMR Vendor:
  8. Point of contact:
  9. Email:

For Stage 1 Meaningful Use, the test must occur on or before the last day of the EHR reporting period. For the first year of Stage 1 Meaningful Use, requiring only a 90 day reporting period, the test may occur before the EHR reporting period commences as long as it is within the calendar year of the reporting period.

Although providers are required to meet a public health menu measure, EPs may attest to an exclusion without jeopardizing their potential of earning an incentive payment. The first exclusion applies to EPs who did not give  immunizations during the EHR reporting period. The second exclusion is "where no immunization registry has the capacity to receive the information electronically." The state immunization registry, the State Immunization Information System (SIIS), currently has the capacity to test HL7 version 2.3.1 and HL7 2.5.1 standard messages electronically. The registry will have the capacity to exchange data HL7 version 2.5.1 standard messages electronically in spring 2013 and can currently exchange data with HL7 version 2.3.1.  The second exclusion does not apply to any professional who has certified EHR technology as long as s/he gives immunizations to any patients, regardless of age, during the reporting period, except when there are other requirements by the registry or vendor that cannot be met. Use the e-mail below to contact us for more information regarding the applicability of an exclusion to a specific situation.

The attestation portal will require the EP to choose yes or no to having completed the test and list the registry and the date of the test. EPs should use the date the most recent message was submitted for testing. Although not required, EPs may choose to upload their letter from the registry confirming the test was performed in the standards mandated by the Standards and Certification Final Rule.

Relevant CMS FAQs

  • 10714: clarifying acceptable reasons for exclusions
  • 10162: instructing how to select five menu measures, including the public health objectives
  • 10764: submitting data via intermediary rather than directly
  • 10713: submitting batch files
  • 10978: conducting a test from a test environment or test domain of certified EHR technology
  • 10979: conducting tests for each physical location if multiple EPs are using the same EHR

Additional Resources

None at this time.

Federal Regulations Governing This Measure

CMS' Final Rule

§ 495.6(3)(9) see objective and measure above

Standards and Certification Final Rule

§ 170.302(k) Submission to immunization registries. Electronically record, modify, retrieve, and submit immunization information in accordance with:

  1. The standard (and applicable implementation specifications) specified in Sec. 170.205(e)(1) or Sec. 170.205(e)(2); and
  2. At a minimum, the version of the standard specified in Sec. 170.207(e).

§ 170.205(e) Electronic submission to immunization registries.

  1. Standard. HL7 2.3.1 (incorporated by reference in Sec. 170.299). Implementation specifications. Implementation Guide for Immunization Data Transactions using Version 2.3.1 of the Health Level Seven (HL7) Standard Protocol Implementation Guide Version 2.2 (incorporated by reference in Sec. 170.299).
  2. Standard. HL7 2.5.1 (incorporated by reference in Sec. 170.299). Implementation specifications. HL7 2.5.1 Implementation Guide for Immunization Messaging Release 1.0 (incorporated by reference in Sec. 170.299).

§ 170.207(e) Immunizations. Standard. HL7 Standard Code Set CVX--Vaccines Administered, July 30, 2009 version (incorporated by reference in Sec. 170.299)..