Capital Blue CrossCommercial · Administrative · Provider News · Pediatrics, Family Medicine, Internal MedicineLow impact
AB2026-08-003 Quality information
Effective date
Not stated in the notice
Identified
Jul 31, 2026
Summary
Capital Blue Cross provides quality information for professional and facility providers on three HEDIS measures: Childhood Immunization Status Combination #10 (CIS-E), the flu vaccine measure, and Immunization for Adolescents Combination #2 (IMA-E). The childhood measure counts children who turned two during the measurement year and received the listed doses of DTaP, IPV, MMR, Hib, HepB, VZV, PCV, HepA, rotavirus and two flu vaccines on or before age two, and parent refusal is not a valid exclusion. The adolescent measure counts 13-year-olds who received one meningococcal vaccine, one Tdap vaccine and the HPV series between the member's 9th and 13th birthdays.
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01Providers: Review each child's date of birth and make sure all vaccines are administered before the second birthday, and use EMR alerts to flag due or overdue vaccines.
02Providers: Schedule well-child visits in line with recommended immunization timelines, and schedule immunizations during annual well visits and sports physicals.
03Providers: Educate patients and caregivers about the importance of completing the HPV vaccine series.
04Providers: Routinely assess adult patients' vaccination history, offer needed vaccines, and use reminder-recall systems.
05Providers: Provide Capital with data for any service that was provided but not captured.
06Use the coding guidance for each measure, which lists the CPT and HCPCS codes for each vaccine.
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