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COVID-19

Immunizations for Adolescents (IMA) – HEDIS Measure

Answer the questions to confirm eligibility and compliance criteria, this is applicable to Medicaid and Commercial members only.

Does the member* turn 13 years of age during the measurement year?

Does the member meet compliance for the specified individual/combination immunization(s) as outlined in the table below?

Table 1: Immunizations for Adolescents and Age Criteria
Immunization Age Criteria Combination Measures Individual Measures
Combination 1 Combination 2 Meningococcal serogroups A, C, W, Y Tdap HPV
Meningococcal serogroups A, C, W, Y On or between the 11th and 13th birthdays Yes Yes Yes - -
Tdap On or between the 10th and 13th birthdays Yes Yes - Yes -
HPV* On or between the 9th and 13th birthdays - Yes - - Yes

Member does not meet eligibility criteria to be included in measure

Billing Codes

  • CVX 32 108 114 136 147 167 203

    Meningococcal Vaccine Procedure

    CPT 90619 90733 90734

    SNOMED CT US Edition 428271000124109 871874000 16298691000119102

  • Tdap Immunization

    CVX 115

    Tdap Vaccine Procedure

    CPT 90715

    SNOMED CT US Edition 428251000124104 390846000 412755006 412756007 412757003 571571000119105

  • HPV Immunization

    CVX 62 118 137 165

    HPV Vaccine Procedure

    CPT 90649 90650 90651

    SNOMED CT US Edition 428741008 428931000 429396009 734152003 717953009 724332002 761841000

Member meets compliance for this measure.