Quality Management Optimizing HEDIS & STARSMedicare AdvantageNovember 26, 2024

HEDIS Category II Coding Bulletin 2025

HEDIS® is a widely used set of performance measures developed and maintained by NCQA. These are used to drive improvement efforts surrounding best practices.

Reduce the number of medical records we request from you during the HEDIS medical record review season (January to May each year) by adding specific CPT® Category II codes to your claims. These codes will help us identify additional information about the visit and improve the accuracy of reporting HEDIS quality measures.

Refer to the attachments for more information.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Medicare services provided by Anthem Blue Cross and Blue Shield, trade name of Anthem HealthChoice HMO, Inc. and Anthem HealthChoice Assurance, Inc., Anthem Blue Cross and Blue Shield HP, trade name of Anthem HP, LLC., or Anthem Blue Cross and Blue Shield Retiree Solutions, trade name of Anthem Insurance Companies, Inc.
Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BC-CR-071946-24-CPN71401, MULTI-BCBS-CR-071947-24-CPN71401

ATTACHMENTS: HEDIS Category II Coding Bulletin 2025 - Blue Cross (pdf - 1.26mb), HEDIS Category II Coding Bulletin 2025 - Blue Cross Blue Shield Medicare Advantage (pdf - 1.26mb)