CommercialDocumentationMedium impact
Closing HEDIS Care Gaps with Patient-Reported A1c Results
Florida Blue·FL · Family Medicine, Internal Medicine, Endocrinology·Quality Measures
We identified it
Jun 16, 2026
Summary
Florida Blue now allows patient-reported HbA1c results from outside providers to close HEDIS diabetes care gaps when properly documented in medical records. Billing teams must use specific CPT II codes (3044F, 3046F, 3051F, 3052F) with the original screening date to report these results.
Action Required
Immediately: Train billing team and providers to document patient-reported HbA1c results in Lab Results/Diabetes Care section with screening date, value, and location. Use appropriate CPT II codes (3044F for <7%, 3046F for >9%, 3051F for 7-8%, 3052F for 8-9%) with original screening date. Update workflows to ask diabetes patients about outside HbA1c screenings at each visit.