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HEDIS Measurement Year (MY) 2023 Provider Tips for Optimizing HEDIS Results

MY 2023 Quality Coding Tips

Eligible Populations, Quality Administrative Value Set Directory Codes and Documentation Requirements

One of the most widely used tools for improving quality and measuring health care plan performance in the United States is the Healthcare Effectiveness Data and Information Set (HEDIS®). HEDIS was developed and is maintained on an annual basis by the National Committee for Quality Assurance (NCQA).

Our participating physicians and other health care professionals play an important role in HEDIS. The care you deliver to your patients, our members, is assessed by the HEDIS quality measures.

Listed below are some key HEDIS measures and corresponding quality coding tips codes and documentation requirements. Please use the codes, as you determine appropriate, to help ensure that patients' charts include accurate, legible and complete medical record documentation.

For additional HEDIS information, contact Horizon Healthy Journey at 1-844-754-2451.