Provider Reference Library: HEDIS Guides

General References for HEDIS Compliance 

• Scheduling Guidelines
• HEDIS FAQs
• How to Close Gaps
• Closing Gaps in Care
• No Show Strategies

Adult Medical Conditions and Preventive Care

• Asthma Medication Ratio (AMR)
• Breast Cancer Screening (BCS-E)
• Colorectal Cancer Screening (COL)
• Controlling High Blood Pressure (CBP)
• Follow-Up After Emergency Department Visit for People with Multiple High-Risk Chronic Conditions (FMC)
• Statin Therapy for Patients with Cardiovascular Disease (SPC)

Behavioral Health Care 

• Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA)
• Antidepressant Medication Management (AMM)
• Diabetes Screening for People with Schizophrenia or Bipolar Disorder who are using Antipsychotic Medications (SSD)
• Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA)
• Follow-Up After Emergency Department Visit for Mental Illness (FUM)
• Follow-up after Hospitalization for Mental Illness (FUH)
• Follow-Up Care for Children Prescribed ADHD Medication for Attention Deficit Disorder (ADD)
• Metabolic Monitoring for Child and Adolescents on Antipsychotics (APM)

Child and Adolescent Care 

• Child and Adolescent Well-Care Visits (WCV)
• Childhood Immunization Status (CIS)
• Follow-Up Care for Children Prescribed ADHD Medication for Attention Deficit Disorder (ADD)
• Immunizations for Adolescents (IMA) 
• Metabolic Monitoring for Child and Adolescents on Antipsychotics (APM)
• Asthma Medication Ratio (AMR)
• Weight Assessment and Counseling for Children and Adolescents (WCC)
• Well-Child Visits in the First 30 Months of Life (W30)

Diabetes Care 

• Blood Pressure Control for Patients with Diabetes (BPD)
• Eye Exam for Patients with Diabetes (EED)
• Hemoglobin A1C Control for Patients Living with Diabetes (HBD)
• Kidney Health Evaluation for Patients Living with Diabetes (KED)
• Statin Therapy for Patients with Diabetes (SPD)

HEDIS Measures and Gaps in Care Resources 

• Closing Gaps in Care in 2023 (PDF) 
• Gaps in Care Timeline (PDF) 
• Medical Records Submission Guidelines (PDF) 
• Gaps in Care Documentation Guidelines (PDF)
• Accessing Gaps in Care Reports Step-by-Step Guide (PDF)
• MVP Provider Online Account Registration Instructions (PDF)
• Primary Care Provider Change or Patient Reassignment Request (PDF)
• Medical Record Transmission Cover Sheet (PDF)
• Transitions of Care (TRC)
• Transitions of Care (TRC) Compliance Overview

Gaps in Care Webinar

The gaps in care submission process outlines how Providers should submit medical record documentation to MVP to close gaps in care identified in MVP reporting. Please review this presentation from the MVP HEDIS Operations Team.