HEDIS FAQs

HEDIS Measures and Technical Resources

More than 235 million people are enrolled in plans that report HEDIS results. That makes HEDIS one of health care’s most widely used performance improvement tools. HEDIS includes measures for physicians, PPOs and other organizations. Visitors to this page often check HEDIS FAQs, QRS FAQs, or ask a question through My NCQA.

HEDIS Measures

HEDIS® measures performance in health care where improvements can make a meaningful difference in people’s lives.

For a full list of HEDIS measures and the latest performance data on HEDIS and CAHPS measures, visit the State of Health Care Quality Report — available for free.

HEDIS Technical Resources

HEDIS Technical Specifications include a complete list of new and updated HEDIS measures with instructions on data collection and guidelines for calculations and sampling.

Vol. 2: Technical Specifications for Health Plans

HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling.

HEDIS Measures Included in the Quality Rating System (QRS)

Quality Rating System Measure Technical Specifications are unique to the issuers offering plans on the Exchange and participating in the CMS Quality Rating System (QRS).

Vol. 3: Specifications for Survey Measures

HEDIS survey measures and standardized surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program.

  • Order this publication (anticipated release date: September 2026)
  • CAHPS 5.1H Survey Certification
  • MY 2026 Validated Member-Level File Layout (anticipated release date: January 2027

Vol. 5: HEDIS Compliance Audit™: Standards, Policies and Procedures

The approved method for auditing the HEDIS production process, including an information systems capabilities assessment, an evaluation of compliance with HEDIS specifications and standards that Certified HEDIS Compliance Auditors must use when conducting a HEDIS audit.

  • Order this publication (anticipated release date: August 2026)
  • HEDIS Compliance Audit
  • HEDIS Volume 5 MY 2026 Specifications Update (anticipated release date: December 2026)

Vol. 6: The Medicare Health Outcomes Survey Manual

Technical specifications for the Health Outcomes Survey (HOS).

HEDIS Technical Specifications for Long-Term Services and Support Measures

The technical specifications for organizations providing Medicaid long-term services and supports (LTSS).

Vol. 1: Narrative

Overview of the HEDIS measurement set and how the data are used.

Vol. 2: Technical Specifications for Health Plans

HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling.

HEDIS Measures Included in the Quality Rating System (QRS)

Quality Rating System Measure Technical Specifications are unique to the issuers offering plans on the Exchange and participating in the CMS Quality Rating System (QRS).

Vol. 3: Specifications for Survey Measures

HEDIS survey measures and standardized surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program.

Vol. 5: HEDIS Compliance Audit™: Standards, Policies and Procedures

The approved method for auditing the HEDIS production process, including an information systems capabilities assessment, an evaluation of compliance with HEDIS specifications and standards that Certified HEDIS Compliance Auditors must use when conducting a HEDIS audit.

Vol. 6: The Medicare Health Outcomes Survey Manual

Technical specifications for the Health Outcomes Survey (HOS).

HEDIS Technical Specifications for Long-Term Services and Support Measures

The technical specifications for organizations providing Medicaid long-term services and supports (LTSS).

Vol. 1: Narrative

Overview of the HEDIS measurement set and how the data are used.

Vol. 2: Technical Specifications for Health Plans

HEDIS nonsurvey measures for organizations; instructions on data collection for each measure; general guidelines for calculations and sampling.

HEDIS Measures Included in the Quality Rating System (QRS)

Quality Rating System Measure Technical Specifications are unique to the issuers offering plans on the Exchange and participating in the CMS Quality Rating System (QRS).

Vol. 3: Specifications for Survey Measures

HEDIS survey measures and standardized surveys from the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) program.

Vol. 5: HEDIS Compliance Audit™: Standards, Policies and Procedures

The approved method for auditing the HEDIS production process, including an information systems capabilities assessment, an evaluation of compliance with HEDIS specifications and standards that Certified HEDIS Compliance Auditors must use when conducting a HEDIS audit.

Vol. 6: The Medicare Health Outcomes Survey Manual

Technical specifications for the Health Outcomes Survey (HOS).

HEDIS Technical Specifications for Long-Term Services and Support Measures

The technical specifications for organizations providing Medicaid long-term services and supports (LTSS).

HEDIS Measurement Year 2023

  1. HEDIS MY 2023 Summary of Changes
  2. HEDIS MY 2023 Measure Descriptions
  3. HEDIS MY 2023 Volume 2 Technical Specifications Update (Updated April 5, 2023)
  4. HEDIS MY 2023 Audit Timeline(Posted March 31, 2023)
  5. HEDIS MY 2023 Risk Adjustment Tables
  6. HEDIS MY 2023 Medication List Directory (NDC codes)
  7. HEDIS MY 2023 Public Reporting Memo(Posted October 2, 2023)
  8. HEDIS MY 2023 Measure Trending Determinations(Updated July 17, 2024)
  9. MY 2023 Quality Rating System Value Set Directory (Posted November 30, 2023)
  10. MY 2023 Technical Specifications Update for the Quality Rating System (Updated April 12, 2023)
  11. MY 2023 Validated Member-Level File Layout(Posted January 4, 2024)

HEDIS Measurement Year 2022

  1. HEDIS MY 2022 Summary of Changes (Updated 7/7/2022)
  2. HEDIS MY 2022 Measure Descriptions
  3. HEDIS MY 2022 Volume 2 Technical Specifications Update (Posted March 31, 2022)
  4. HEDIS MY 2022 Audit Timeline
  5. HEDIS MY 2022 Risk Adjustment Tables 
  6. HEDIS MY 2022 Medication List Directory (NDC codes)
  7. HEDIS MY 2022 Public Reporting Memo
  8. HEDIS MY 2022 Measure Trending Determinations
  9. MY 2022 Quality Rating System Value Set Directory (Posted March 31, 2022)
  10. MY 2022 Quality Rating System Technical Specifications
  11. MY 2022 Technical Specifications Update for the Quality Rating System (Posted March 31, 2022)
  12. Volume 3 MY 2022 Validated Member-Level File Layout (Posted January 9, 2023)
  13. Volume 5 Specification Updates (Posted December 15, 2022)

The National Drug Code (NDC) Lists are provided by Cerner Multum, Inc. (“Multum”) and are intended for organizations that use NCQA’s HEDIS information.

Rules for Allowable Adjustments of HEDIS

Recognizing that HEDIS measures have traditionally been specified for health plan reporting, NCQA developed the Rules for Allowable Adjustment of HEDIS to accommodate the application of HEDIS measures to various levels of the health care system for quality improvement initiatives. The rules provide flexibility for evaluating different populations without altering measures’ clinical intent (e.g., removal of continuous enrollment or product-line criteria).

The Rules for Allowable Adjustments are included in the HEDIS Volume 2 publication after the applicable HEDIS measure specifications. NCQA’s HEDIS Value Set Directory (VSD) includes the necessary third-party codes for use with adjusted measure specifications.

HEDIS FAQ

Visitors to this page often check HEDIS FAQs or ask a question through MyNCQA.

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

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

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