Summary
Age 42 at measurement-period end in CMS125FHIR is a reporting-population rule, not a recommendation to defer initial mammography until age 42.
Detail
Reviewed on 2026-11-03. The pinned CQL uses ages 42 through 74 at period end and a mammography window beginning October 1 two years before the measurement year. Its strata are ages 42–51 and 52–74. Interpret these definitions together with exclusions and qualifying encounters, rather than comparing an age expression alone with clinical guidance.
The USPSTF final recommendation (April 30, 2024) recommends biennial mammography for women ages 40–74 in its specified screening population. The 2026 CMS eligible-clinician measure table likewise describes screening ages 40–74, but specifies women ages 42–74 at period end for the initial population and a 27-month screening window. The 2026 technical release notes state that the initial-population age was changed from 52–74 to 42–74 to align with updated USPSTF guidance.
These published QDM materials support interpreting the end-of-period age in its reporting context. They do not prove complete equivalence with this draft FHIR package or resolve every birth-date and time-boundary case. The 27-month reporting window is not itself a clinical recommendation for a 27-month interval. This note does not assess competing society recommendations or high-risk protocols.
Resolution
Open for clinical and implementation review. The age expression alone is not evidence of an outdated starting age or a confirmed defect. Remaining work is an executable set of birth-date, mammogram-window, and exclusion boundary cases.