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Quality Measures Track Treatment and Follow-Up Visits for Substance Use Disorders
BCBS Texas·TX · Psychiatry, Family Medicine, Internal Medicine +2 more·General
Effective date
Mar 4, 2026
We identified it
Jun 13, 2026
Summary
Blue Cross Blue Star of Texas has updated their substance use disorder quality measures tracking policy, outlining specific HEDIS measures they monitor including treatment initiation within 14 days, follow-up visits within 7-34 days, and pharmacotherapy requirements. This is primarily informational guidance for providers on documentation and care coordination to improve quality measure performance.
Action Required
Immediately: Providers should ensure consistent use of substance use disorder diagnosis codes at each follow-up visit and coordinate care documentation between behavioral health and primary care providers. Billing team should verify that substance use disorder visits are properly documented with appropriate diagnosis codes to support quality measure tracking. Reschedule cancelled appointments promptly to meet follow-up timeframes.