CommercialAdministrativeMedium impact
HEDIS Follow-Up Care for Children Prescribed ADHD Medication (ADD)
Blue Cross Blue Shield of Rhode Island·RI · Pediatrics, Psychiatry, Family Medicine·Behavioral Health
Effective date
Dec 1, 2024
We identified it
Jun 19, 2026
Summary
BCBSRI is implementing HEDIS Follow-Up Care requirements for children prescribed ADHD medication, requiring at least three follow-up visits within 10 months with one visit within 30 days of first prescription dispensing. This affects quality measure reporting and potentially reimbursement for pediatric ADHD care.
Action Required
Immediately: Billing team and providers must ensure ADHD medication follow-up visits are properly scheduled and documented. Schedule initial follow-up within 30 days of first ADHD prescription and ensure at least three total visits within 10 months. Update EMR templates to track HEDIS ADD measure compliance. Document all follow-up visits with appropriate evaluation codes to support quality reporting.