Yes. This data element is a calculated field in IDSS, and it should be shaded gray. We will correct this in the release of the MY 2026 Volume 2 Technical Specifications.
HEDIS MY 2025
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Yes. As described in Numerator 5—Immunization Status: Hepatitis B, use POS code 81 to exclude laboratory claims when identifying members with a history of hepatitis B illness. POS code 81 was mistakenly omitted from the Direct Reference Code tab of the VSD. Because the information needed for reporting is in the measure specification, NCQA does not intend to reissue the VSD.
HEDIS MY 2025
No. The codes are for “amitriptyline hydrochloride 25 MG/chlordiazepoxide 10 MG Oral Tablet.” They belong only in the Chlordiazepoxide 10 MG Medications List. NCQA re-released the MY 2025 Medication List directory on May 15, 2025, to incorporate this update. NCQA’s Measure Certification program confirmed that certification organizations deleted the codes from the Chlordiazepoxide 25 MG Medications List. No changes to the current process are necessary.
HEDIS MY 2025
An error was identified in the HEDIS MY 2024 Medication List Directory (released on April 1, 2024). For the Asthma Medication Ratio (AMR) measure, “package size” and “unit” are required to perform calculations. If we cannot find package size and unit for NDC codes, we cannot include the codes in the AMR medication lists. For the MY 2024 Update release of the MLD, an alternative method was used to identify package size and unit so more codes could be included in the medication lists. Because this method resulted in incorrect information, we removed these codes from 11 medication lists.
Three medication lists were removed from the AMR measure.
Customers who purchased the HEDIS MY 2024 Medication List Directory should re-download the file from the My Downloads section of their My NCQA account. Customers who purchased a product that contains the AMR measure specification should delete the three medication lists, consistent with how changes from the technical update are applied.
HEDIS MY 2024
NCQA will remove the RAND table from the Guidelines for Calculations and Sampling with the release of the HEDIS MY 2025 Technical Update on March 31, 2025. Future releases of the HEDIS Volume 2: Technical Specifications for Health Plans publication will not contain a RAND table.
Beginning MY 2025, NCQA will use an alternative timeline and approach to distribute RAND numbers for HEDIS reporting. This information will be released in the NCQA store for purchasers of HEDIS Volume 2 in the November before production of systematic samples for hybrid reporting (e.g., November 2025, for MY 2025).
Organizations participating in NCQA’s Measure Certification program will receive separate guidance on how NCQA will accommodate this change for certification of systematic sampling logic.
HEDIS MY 2025
Common themes include:
Another arrangement that may exist includes workflows where providers (e.g., NPs, PAs) contact a plan’s membership annually to assess a member’s medical history, including when they received their last cancer screenings. It is unclear if a singular touchpoint by the NP/PA indicates that the provider has clinical accountability for the member’s care. Organizations are not allowed to call members to collect data.
HEDIS MY 2025
HEDIS Volume 2 provides guidance in several places:
HEDIS MY 2025
Example: During a new-patient office visit, the patient reports receiving a colonoscopy in the previous year to their primary care provider. During the discussion, the provider documents the details (when and where the procedure occurred, findings) in the office visit progress notes in the patient’s EHR.
This example represents the intent behind the HEDIS guidelines because:
HEDIS MY 2025
The Colorectal Cancer Screening (COL-E) measure is based on the US Preventive Services Task Force (USPSTF) guidelines for colorectal cancer screening. The guidelines do not recommend serum (blood) testing (e.g., blood-based biomarker) and for this reason it does not meet criteria for the HEDIS measure. NCQA continually monitors clinical practice guidelines as they are updated.
HEDIS MY 2025