CommercialAdministrativeMedium impact
Hints for HEDIS®: Childhood Immunization Status (CIS)
Blue Cross Blue Shield of Rhode Island·RI · Pediatrics, Family Medicine·Physician
Effective date
Dec 1, 2022
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Rhode Island updated guidance for HEDIS Childhood Immunization Status (CIS) measure, emphasizing influenza vaccination requirements for children turning 2 during the measurement year. The policy provides specific CPT and HCPCS codes for billing influenza immunizations and clarifies that children need at least 2 flu vaccinations with different dates of service by their second birthday.
Action Required
Billing team should verify that influenza vaccination claims for children under 2 use the specified CPT codes (90655, 90657, 90661, 90673, 90674, 90685, 90686, 90687, 90688, 90689, 90756) or HCPCS code G0008. Ensure documentation shows at least 2 flu vaccinations with different dates of service before the child's second birthday, with no vaccinations billed if administered before 6 months of age. Contact QualityHEDIS@bcbsri.org for questions.