Our updated 2024 HEDIS Provider Reference Guide is now available

We recently updated our 2024 HEDIS Provider Reference Guide.

To access the guide, log into your prism account and navigate to Provider Incentive Programs, then Quality Improvement. You can then bookmark the manual URL in your browser for quick access.

Here’s a summary of the changes:

Glycemic Status Assessment for Patients with Diabetes (GSD) measure
Updated verbiage to state that Medicare patients are considered controlled if A1c is < 9.0%.

Kidney Health Evaluation for Patients with Diabetes (KED) measure
Updated numerator compliance to include:

• At least one eGFR
• At least one uACR identified by either of the following:
• A uACR or
• Both a quantitative urine albumin test and a urine creatinine test with service dates four days or less apart. For example, if the service date for the quantitative urine albumin test was December 1 of the measurement year, then the urine creatinine test must have a service date on or between November 27 and December 5 of the measurement year.

Billing codes were updated for the following measures:

•  Prenatal and Postpartum Care (PPC)
• Chlamydia Screening in Women (CHL)
• Eye Exam for Patients with Diabetes (EED)
• Care for Older Adults (COA) – Functional Status Assessment
• Care for Older Adults (COA) – Medication Review
• Care for Older Adults (COA) – Pain Assessment
• Advance Care Planning (ACP)
• Adults’ Access to Preventive/Ambulatory Health Services (AAP)
• Lead Screening in Children (LSC)
• Child and Adolescent Well-Care Visits (WCV)
• Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)
• Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)