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Florida BlueMedicare Advantage · Documentation · Provider Bulletin · FL · Cardiology, Internal Medicine, Family Medicine +4 moreHigh impact

Every Reading Counts: Your Contribution to Better Blood Pressure Outcomes

Effective date
Jul 1, 2026
Identified
Jul 29, 2026

Summary

Florida Blue has issued updated guidance on blood pressure management documentation and coding for HEDIS reporting. Providers must now document exact blood pressure readings (no rounding or ranges), utilize specific CPT II codes (3074F-3080F) based on systolic/diastolic thresholds, and assign appropriate ICD-10 codes for hypertensive conditions. This change emphasizes detailed documentation to support quality measure compliance and care management targeting.

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What to do

Action · 8 steps
01Effective immediately (July 2026): Billing and clinical teams must implement the following changes.
02Providers must document exact blood pressure values at all patient visits without rounding, ranges, or averages—update EMR templates and provider encounter forms to enforce this requirement.
03Billing team must update software to assign CPT II codes 3074F, 3075F, or 3077F for systolic readings and 3078F, 3079F, or 3080F for diastolic readings based on the specified thresholds.
04Coders must select appropriate ICD-10 codes from the provided reference guide (I10, I11.0, I11.9, I12.0, I12.9, I13.0, I13.10, I13.2, I15, I16, I1A, R03.0) and ensure secondary codes for heart failure and CKD stages are included when applicable.
05Front-line clinical staff should encourage home blood pressure monitoring during telehealth visits.
06Non-compliant readings (systolic ≥140 mmHg or diastolic ≥90 mmHg) must be flagged and submitted for HEDIS reporting to support care management outreach.
07Failure to comply will result in inaccurate HEDIS quality measure reporting and missed opportunities for member care management initiatives.
08Contact MedicareStarsTeam@bcbsfl.com with questions.

Codes mentioned

I10I11.0I11.9I12.0I12.9I13.0I13.10I13.2I15I16R03.0

Original notice

Every Reading Counts: Your Contribution to Better Blood Pressure Outcomes
files.guidewell.com · Always check the source before changing claims.
View original ↗

Related changes

See all Florida Blue changes →
Florida Blue Medicare Risk Adjustment Best Practices and Coding Educational Guide, 2023MediumNo effective date · CodingBrowse every Florida Blue change in the policy list

Related policy hubs

Florida Blue policiesFL policy changesCardiologyInternal MedicineFamily MedicineGeneral PracticeGeriatricsNephrologyEndocrinologyCode I10Code I11.0Code I11.9Code I12.0Code I12.9Code I13.0Code I13.10Code I13.2Code I15Code I16Code R03.0

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