All PlansAdministrativeMedium impact
Quality Measures Track Treatment and Follow-Up Visits for Substance Use Disorders
BCBS Texas·TX · Psychiatry, Family Medicine, Internal Medicine +1 more·General
Effective date
Mar 13, 2025
We identified it
Jan 12, 2026
Summary
Blue Cross Blue Star Texas has published quality measure tracking requirements for substance use disorder (SUD) treatment and follow-up visits. This policy outlines HEDIS measures that monitor initiation, engagement, and follow-up care for SUD patients ages 13 and older, emphasizing the importance of timely follow-up visits and consistent diagnosis coding.
Action Required
Immediately: Providers and billing teams should ensure consistent use of SUD diagnosis codes across all follow-up visits. Update documentation practices to coordinate care between behavioral health and primary care providers, sharing progress notes with SUD diagnoses. Implement follow-up scheduling protocols to contact members who cancel SUD-related appointments and help reschedule within required timeframes (7-30 days depending on measure).