CommercialBilling CodesMedium impact
Hints for HEDIS (and more)
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, Cardiology +3 more·Physician
Effective date
Jan 1, 2021
We identified it
Jun 19, 2026
Summary
BCBS Rhode Island updated blood pressure control quality measure specifications, lowering the systolic blood pressure threshold from 140/90 to 130/90 mm Hg for HEDIS reporting. New specific billing codes are now required to report blood pressure readings for quality measure compliance.
Action Required
Billing team must update quality reporting procedures to use the new blood pressure CPT Category II codes (3074F-3080F) when documenting blood pressure readings for hypertension patients. Update EMR templates to capture most recent BP readings with appropriate codes. Ensure providers understand the new 130/90 threshold for controlled hypertension reporting.