Quality Measures Track Treatment and Follow-Up Visits for Substance Use Disorders
AI 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).
Plan Types
All Plans
States
TX
Specialties
psychiatry, family-medicine, internal-medicine, emergency-medicine, hospitalist