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.

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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).

Development and Maintenance of HEDIS Measures

NCQA has been an independent convener of healthcare stakeholders for more than 35 years, reinforcing trust, credibility and alignment with high-quality clinical practice. Our mission to improve health care quality is grounded in a rigorous, independent approach to determining what constitutes the best available evidence and translating that evidence into meaningful quality measures.  

We independently identify the best available evidence and translate it into meaningful quality measures using recognized scientific methodologies and informed consensus.

NCQA builds its measures using strong, carefully reviewed evidence. We do not write clinical guidelines. Instead, we look at how trusted organizations review research and develop guidelines using well-established scientific methods. We consider guidance and evidence reviews from organizations including, but not limited to, leading medical associations, recognized guideline developers, governmental entities and all sources of best available evidence when developing quality measures.

In some areas, recommendations reflect clear clinical consensus, and in others, recommendations may vary. In all cases, NCQA assesses the methodological rigor of how clinical guidance is developed and gives greatest weight to recommendations informed by comprehensive literature reviews, explicit assessments of evidence quality, structured evidence-to-decision frameworks, transparent recommendation development, robust conflict-of-interest management and balanced consideration of benefits, harms, equity, feasibility and patient values. This ensures that NCQA’s measures are aligned with scientifically sound and methodologically credible standards of care.

The evidence review is paired with structured deliberation through our established governance processes that bring together multidisciplinary expertise to interpret the evidence and guide measure development decisions. NCQA committees, specifically the Committee on Performance Measurement, and advisory panels bring diverse perspectives and clinical, methodological and operational expertise to ensure that evidence is interpreted consistently and applied appropriately within quality measurement. Public comment periods offer channels for the broader community to engage as well. HEDIS® measures are approved by the NCQA Board.

As new evidence becomes available and the healthcare system evolves, we evaluate measures to determine when updates, retirement or replacement are appropriate using the process described above. Evaluation ensures the measures remain evidence-based, clinically meaningful and feasible to implement.

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