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COVID-19

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

HEDIS Measure

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

Line of business: Commercial Medicaid Medicare

Data Collection Method: Administrative

Measure Description

The percentage of members 20 years of age and older who had an ambulatory or preventive care visit.

Numerator Compliance

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.

Best Practices

  • Encourage patients to maintain the relationship with a PCP to promote consistent and coordinated health care
  • Educate patients on the importance of having at least one ambulatory or preventive care visit during each measurement year
  • Consider offering extended practice hours to increase care access
  • Remind patients of their appointment by making calls or sending texts
  • Make outreach calls and/or send letters to advise members of the need for a visit
  • Partner with Horizon Healthy Journey Program to assist with targeted outreach activities

Quality Value Set Directory Coding Tips

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