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Adults’ Access to Preventive/ Ambulatory Health Services (AAP)

Based on current NCQA HEDIS recommendations, your TO-DO LIST for members 20 years of age and older should include:

  • Complete an ambulatory or preventive care visit during the measurement year.

Why should you complete your TO-DO LIST?

It is an evidence-based, best practice and these actions are used to measure your quality performance.

HEDIS Adults’ Access to Preventive/Ambulatory Health Services (AAP) Definition:

(NCQA HEDIS guidelines, Measurement Year (MY) 2022)

The percentage of members 20 years and older who had an ambulatory or preventive care visit. The organization reports three separate percentages for each product line.

  • Medicaid and Medicare members who had an ambulatory or preventive care visit during the measurement year
  • Commercial members who had an ambulatory or preventive care visit during the measurement year or the two years prior to the measurement year

Requirement:

  • Medicaid and Medicare: One or more ambulatory or preventive care visits during the measurement year
  • Commercial: One or more ambulatory or preventive care visits during the measurement year or the two years prior to the measurement year

Use the following value sets to identify ambulatory or preventive care visits:

  • Ambulatory Visits Value Set
  • Other Ambulatory Visits Value Set
  • Telephone Visits Value Set
  • Online Assessments Value Set

How does your completion of the TO-DO LIST get recorded?

Ambulatory Visits

CPT 99201 99202 99203 99204 99205 99211 99212 99213 99214 99215 99241 99242 99243 99244 99245 99341 99342 99343 99344 99345 99347 99348 99349 99350 99381 99382 99383 99384 99385 99386 99387 99391 99392 99393 99394 99395 99396 99397 99401 99402 99403 99404 99411 99412 99429 99483

HCPCS G0402 G0438 G0439 G0463 T1015

ICD10CM Z00.00 Z00.01 Z00.121 Z00.129 Z00.3 Z00.5 Z00.8 Z02.0 Z02.1 Z02.2 Z02.3 Z02.4 Z02.5 Z02.6 Z02.71 Z02.79 Z02.81 Z02.82 Z02.83 Z02.89 Z02.9 Z76.1 Z76.2 V20.2 V70.0 V70.3 V70.5 V70.6 V70.8 V70.9

SNOMED CT US Edition 962000 2219003 3089009 4197006 4708004 4967002 6391003 11411001 11867000 11961000 15195005 16457003 21695004 22869000 26377005 27874004 28652005 30775000 32511005 34715004 35090008 36685002 37051008 39698007 40361008 47163004 58634008 59486003 59983003 61416008 68658005 71622008 74559003 78909009 82303003 84497008 84992006 87838003 88284004 89430006 91545002 162651007 162655003 162666005 162680003 170107008 170109006 170110001 170111002 170112009 170114005 170118008 170119000 170120006 170121005 170123008 170127009 170128004 170129007 170130002 170132005 170136008 170137004 170138009 170139001 170141000 170145009 170146005 170147001 170148006 170150003 170154007 170155008 170156009 170157000 170159002 170163009 170164003 170165002 170166001 170168000 170172001 170173006 170174000 170175004 170181007 170182000 170183005 170184004 170250008 170254004 170258001 170259009 170260004 170261000 170263002 170267001 170268006 170269003 170270002 170272005 170276008 170277004 170278009 170279001 170281004 170285008 170286009 170287000 170288005 170290006 170294002 170295001 170296000 170297009 170300004 170305009 170306005 170307001 170308006 170309003 185351004 243788004 268563000 268565007 275725007 275726008 275923005 281029006 281030001 281031002 281032009 310367004 365857001 401140000 408485004 408500009 408502001 408503006 410620009 410622001 410623006 410624000 410625004 410626003 410627007 410628002 410629005 410630000 410631001 410632008 410633003 410634009 410635005 410636006 410637002 410638007 410639004 410640002 410641003 410642005 410643000 410644006 410645007 410646008 410647004 410648009 410649001 410650001 442162000 699134002 712791009 713020001 783260003

UBREV 0510 0511 0512 0513 0514 0515 0516 0517 0519 0520 0521 0522 0523 0526 0527 0528 0529 0982 0983


Online Assessments

CPT 98969 98970 98971 98972 99421 99422 99423 99444 99457

HCPCS G0071 G2010 G2012 G2061 G2062 G2063


Telephone Visits

CPT 98966 98967 98968 99441 99442 99443

SNOMED CT US Edition 185317003 314849005 386472008 386473003 401267002


Other Ambulatory Visits

CPT 92002 92004 92012 92014 99304 99305 99306 99307 99308 99309 99310 99315 99316 99318 99324 99325 99326 99327 99328 99334 99335 99336 99337

HCPCS S0620 S0621

SNOMED CT US Edition 18170008 19681004 207195004 209099002 210098006

UBREV 0524 0525


To learn more about your practice’s current HEDIS performance for this or other measures, or for assistance in compliance with the HEDIS guidelines, please contact Horizon Healthy Journey: 1-844-754-2451.

Reference: NCQA HEDIS Measurement Year (MY) 2022 Technical Specs CPT® is a registered trademark of the American Medical Association.