Behavioral Health Measures from HEDIS®

Dec.19, 2019

We've created behavioral health tip sheets to help you satisfy Healthcare Effectiveness Data and Information Set (HEDIS) measures and code appropriately. These measures from the National Committee for Quality Assurance (NCQA) help ensure our members receive appropriate care.

The tip sheets include measurement requirements, medical record best practices and billing codes. Compliance with HEDIS measures reduces the need for you to send medical records later for review.

  • Newly1filled attention-deficit hyperactivity disorder (ADHD) medication
  • Prescribed in the ambulatory setting

Antidepressant Medication Management (AMM) Tip Sheet

  • Members ages 18 and older
  • Diagnosed with major depression
  • Newly2filled antidepressant medication

Diabetes Screening for Members Taking Antipsychotics (SSD) Tip Sheet

  • Members ages 18 to 64
  • Diagnosed with schizophrenia, schizoaffective disorder or bipolar disorder
  • Received an antipsychotic medication at any time during the year

Follow-Up Care for Children Prescribed ADHD Medication (ADD) Tip Sheet

  • Children ages 6 to 12


1Defined as no ADHD medication filled in past 120 days
1Defined as no antidepressant medication filled in past 105 days

HEDIS®is a registered trademark of NCQA.

The above material is for informational purposes only and is not intended to be a substitute for the independent medical judgment of a physician. Physicians and other health care providers are encouraged to use their own best medical judgment based upon all available information and the condition of the patient in determining the best course of treatment.