Oakland Southfield Physicians

OSP News

Blue Cross Complete HEDIS Telehealth Guidelines

Posted: 11/05/2020

Blue Cross Complete wants to let you know that you can close your member care gaps and meet the National Committee for Quality Assurance (NCQA) HEDIS guidelines by utilizing telehealth visits for your member.

Telehealth visits can capture the following HEDIS measures when you apply the appropriate modifiers or place of service codes: Controlling High Blood Pressure (CBP), Comprehensive Diabetes Care (CDC), Care for Older Adults (COA), Prenatal and Postpartum Care (PPC), Weight Assessment Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC), Child and Adolescent Well-Care Visits (WCV), Well-Child Visits in the First 30 Months of Life (W30), and Transitions of Care (TRC).

Telephone visits can help close HEDIS gaps for CBP, CDC, and TRC.

Member reported height, weight, and blood pressure readings are now acceptable for many HEDIS measures if the information is collected by a primary care practitioner or specialist, or if the specialist is providing a primary care service related to the condition being assessed, while taking a patient’s history. The information must be recorded, dated and maintained in the member’s legal health record.

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