HEDIS Measures
HEDIS® measures performance in health care where improvements can make a meaningful difference in people’s lives.
Effectiveness of Care
Prevention and Screening
- Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC)
- Childhood Immunization Status (CIS)
- Immunizations for Adolescents (IMA)
- Lead Screening in Children (LSC)
- Breast Cancer Screening (BCS)
- Cervical Cancer Screening (CCS)
- Colorectal Cancer Screening (COL)
- Chlamydia Screening in Women (CHL)
- Care for Older Adults (COA)
Respiratory Conditions
- Appropriate Testing for Pharyngitis (CWP)
- Use of Spirometry Testing in the Assessment and Diagnosis of COPD (SPR)
- Pharmacotherapy Management of COPD Exacerbation (PCE)
- Asthma Medication Ratio (AMR)
Cardiovascular Conditions
- Controlling High Blood Pressure (CBP)
- Persistence of Beta-Blocker Treatment After a Heart Attack (PBH)
- Statin Therapy for Patients With Cardiovascular Disease and Diabetes (SPC, SPD)
- Cardiac Rehabilitation (CRE)
Diabetes
Musculoskeletal Conditions
Behavioral Health
- Antidepressant Medication Management (AMM)
- Follow-Up Care for Children Prescribed ADHD Medication (ADD)
- Follow-Up After Hospitalization for Mental Illness (FUH)
- Follow-Up After Emergency Department Visit for Mental Illness (FUM)
- Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA)
- Diabetes and Cardiovascular Disease Screening and Monitoring for People With Schizophrenia or Bipolar Disorder (SSD, SMD, SMC)
- Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA)
- Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)
- Pharmacotherapy for Opioid Use Disorder (POD)
- Follow-Up After High-Intensity Care for Substance Use Disorder (FUI)
Medication Management and Care Coordination
- Transitions of Care (TRC)
- Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC)
Overuse/Appropriateness
- Non-Recommended Cervical Cancer Screening in Adolescent Females (NCS)
- Non-Recommended PSA-Based Screening in Older Men (PSA)
- Appropriate Treatment for Upper Respiratory Infection (URI)
- Avoidance of Antibiotic Treatment for Acute Bronchitis/Bronchiolitis (AAB)
- Use of Imaging Studies for Low Back Pain (LBP)
- Medication Management in Older Adults (DDE, DAE)
- Use of Opioids at High Dosage (HDO)
- Use of Opioids from Multiple Providers (UOP)
- Risk of Continued Opioid Use (COU)
Measures Collected Through the Medicare Health Outcomes Survey
- Fall Risk Management (FRM)
- Management of Urinary Incontinence in Older Adults (MUI)
- Physical Activity in Older Adults (PAO)
Measures Collected Through the CAHPS® Health Plan Survey
Access/Availability of Care
Utilization
Risk Adjusted Utilization
Measures Reported Using Electronic Clinical Data Systems
- Breast Cancer Screening (BCS-E)
- Colorectal Cancer Screening (COL-E)
- Follow-Up Care for Children Prescribed ADHD Medication (ADD-E)
- Depression Screening and Follow-Up for Adolescents and Adults (DSF-E)
- Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults (EMS-E)
- Depression Remission or Response for Adolescents and Adults (DRR-E)
- Unhealthy Alcohol Use Screening and Follow-Up (ASF-E)
- Adult Immunization Status (AIS-E)
- Prenatal Immunization Status (PRS-E)
- Prenatal Depression Screening and Follow-up (PND-E)
- Postpartum Depression Screening and Follow-up (PDS-E)
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.
HEDIS Measurement Year 2024
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.
- Order this publication
- Order the HEDIS MY 2024 Digital Measures Bundle
- Technical Specifications Update (Anticipated Release Date: April 1, 2024)
- HEDIS MY 2024 Audit Timeline (Anticipated Release Date: April 1, 2024)
- HEDIS MY 2024 Risk Adjustment Tables (Anticipated Release Date: April 1, 2024)
Note: The Risk Adjustment Tables is available for free order in the NCQA Store. Once ordered, the Risk Adjustment Tables is made available in the “My Downloads” tab on My NCQA.” - HEDIS MY 2024 Medication List Directory (NDC codes) (Anticipated Release Date: April 1, 2024)
Note: The Medication List Directory is available for free order in the NCQA Store. Once ordered, the Medication List Directory is made available in the “My Downloads” tab on My NCQA.” - HEDIS MY 2024 Public Reporting Memo (Anticipated Release Date: October 1, 2024)
- HEDIS MY 2024 Measure Trending Determinations (Anticipated Release Date: Summer 2024)
- HEDIS Electronic Clinical Data System (ECDS)
- HEDIS FAQs
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).
- MY 2024 HEDIS for the Quality Rating System Value Set Directory (Anticipated Release Date: April 1, 2024)
- HEDIS for the Quality Rating System Technical Specifications
- MY 2024 Quality Rating System: Technical Update (Anticipated Release Date: April 1, 2024)
- HEDIS for the Quality Rating System FAQs
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 2024)
- CAHPS 5.1H Survey
- Survey Vendor Certification Program
- MY 2024 Validated Member-Level File Layout (Anticipated Release Date: January 2025)
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 2024)
- HEDIS Compliance Audit
- Specification Updates (Anticipated Release Date: December 2024)
Vol. 6: The Medicare Health Outcomes Survey Manual
Technical specifications for the Health Outcomes Survey (HOS).
- Order this publication (Anticipated Release Date: May 2025)
- Health Outcomes Survey
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
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.
- Order this publication
- Order the HEDIS MY 2023 Digital Measures Bundle
- Technical Specifications Update (Updated April 5, 2023)
- HEDIS MY 2023 Audit Timeline (Posted March 31, 2023)
- HEDIS MY 2023 Risk Adjustment Tables (Posted March 31, 2023)
Note: The Risk Adjustment Tables is available for free order in the NCQA Store. Once ordered, the Risk Adjustment Tables is made available in the “My Downloads” tab on My NCQA.” - HEDIS MY 2023 Medication List Directory (NDC codes) (Posted March 31, 2023)
Note: The Medication List Directory is available for free order in the NCQA Store. Once ordered, the Medication List Directory is made available in the “My Downloads” tab on My NCQA.” - HEDIS MY 2023 Public Reporting Memo (Anticipated Release Date: October 2, 2023)
- HEDIS MY 2023 Measure Trending Determinations (Posted May 18, 2023)
- HEDIS Electronic Clinical Data System (ECDS)
- HEDIS FAQs
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).
- HEDIS for the Quality Rating System Value Set Directory (Posted March 31, 2023)
- HEDIS for the Quality Rating System Technical Specifications
- Technical Specifications Update for the Quality Rating System (Updated April 12, 2023)
- HEDIS for the Quality Rating System FAQs
Technical Specifications for ACO Measurement
HEDIS quality measures for Accountable Care Organizations.
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 (Posted May 1, 2023)
- CAHPS 5.1H Survey
- Survey Vendor Certification Program
- MY 2023 Validated Member-Level File Layout (Anticipated Release Date: January 2024)
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: October 2023)
- HEDIS Compliance Audit
- Specification Updates (anticipated release date: December 2023)
Vol. 6: The Medicare Health Outcomes Survey Manual
Technical specifications for the Health Outcomes Survey (HOS).
- Order this publication (anticipated release date: May 2024)
- Health Outcomes Survey
HEDIS Technical Specifications for Long-Term Services and Support Measures
The technical specifications for organizations providing Medicaid long-term services and supports (LTSS).
- Order this publication (Anticipated Release Date: August 2022)
- Long-Term Services and Supports Programs
HEDIS Measurement Year 2022
Vol. 1: Narrative
Overview of the HEDIS measurement set and how the data are used.
- Order this publication
- HEDIS MY 2022 Summary of Changes (Updated 7/7/2022)
- HEDIS MY 2022 Measure Descriptions
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.
- Order this publication
- Order the HEDS MY 2022 Digital Measures Bundle (includes HEDIS Volume 2)
- Technical Specifications Update (Posted March 31, 2022)
- HEDIS MY 2022 Audit Timeline (Posted March 31, 2022)
- HEDIS MY 2022 Risk Adjustment Tables (Posted March 31, 2022)
Note: The Risk Adjustment Tables are available for free order in the NCQA Store. Once ordered, the Risk Adjustment Tables will be made available in the “My Downloads” tab on My NCQA.” - HEDIS MY 2022 Medication List Directory (NDC codes) (Posted March 31, 2022)
- Note: The Medication List Directory is available for free order in the NCQA Store. Once ordered, the Medication List Directory will be made available in the “My Downloads” tab on My NCQA.”
- HEDIS MY 2022 Public Reporting Memo (Posted October 4, 2022)
- HEDIS MY 2022 Measure Trending Determinations (Updated November 22, 2022)
- HEDIS Electronic Clinical Data System (ECDS)
- HEDIS FAQs
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).
- HEDIS for the Quality Rating System Value Set Directory (Posted March 31, 2022)
- HEDIS for the Quality Rating System Technical Specifications
- Technical Specifications Update for the Quality Rating System (Posted March 31, 2022)
- HEDIS for the Quality Rating System FAQs
Technical Specifications for ACO Measurement
HEDIS quality measures for Accountable Care Organizations.
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
- CAHPS 5.1H Survey
- Survey Vendor Certification Program
- MY 2022 Validated Member-Level File Layout (Posted January 9, 2023)
- Technical Specifications Update (Posted November 15, 2022)
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
- HEDIS Compliance Audit
- Specification Updates (Posted December 15, 2022)
Vol. 6: The Medicare Health Outcomes Survey Manual
Technical specifications for the Health Outcomes Survey (HOS).
- Order this publication (Posted: May 12, 2023)
- Health Outcomes Survey
HEDIS Technical Specifications for Long-Term Services and Support Measures
The technical specifications for organizations providing Medicaid long-term services and supports (LTSS).
HEDIS Archives
HEDIS Measurement Year 2021
- HEDIS MY 2020 & MY 2021 (pdf)
- HEDIS MY 2021 Volume 2 Technical Specifications Update (Posted March 31, 2021)
- HEDIS MY 2021 Risk Adjustment Tables (Posted April 30, 2021)
- HEDIS MY 2021 Medication List Directory (NDC codes)
- HEDIS MY 2021 Public Reporting Memo (Posted October 1, 2021)
- HEDIS MY 2021 Measure Trending Determinations
- MY 2021 Quality Rating System Value Set Directory
- MY 2021 Quality Rating System: Technical Update
- MY 2021 Volume 5 Technical Specifications Update
- Volume 3 MY 2021 Validated Member-Level File Layout
HEDIS Measurement Year 2020
- HEDIS MY 2020 & MY 2021 (pdf)
- HEDIS MY 2020 Volume 2 Technical Specifications Update (Posted October 1, 2020)
- HEDIS MY 2020 Risk Adjustment Tables (Posted November 2, 2020)
- NCQA HEDIS Measurement Year (MY) 2020 Requirements and COVID-19 (December 4, 2020)
- HEDIS MY 2020 Medication List Directory (NDC codes)
- HEDIS MY 2020 Measure Trending Determinations
- MY 2020 Quality Rating System Value Set Directory
- MY 2020 Quality Rating System: Technical Update
- MY 2020 Volume 3 Technical Specifications Update
- Volume 3 MY 2020 Validated Member-Level File Layout
- Volume 3 MY 2020 Specification Updates
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).