Medicare AdvantageBilling CodesMedium impact
Hints for HEDIS® (and more)
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, Endocrinology +3 more·Physician
Effective date
Nov 1, 2020
We identified it
Jun 19, 2026
Summary
BCBSRI has released a comprehensive reference guide for HEDIS quality measures focused on comprehensive diabetes care, providing specific CPT Category II codes for tracking care gaps including HbA1c testing, eye exams, nephropathy screening, and blood pressure control. The policy includes detailed billing codes to help practices close care gaps and improve quality reporting for diabetic patients ages 18-75.
Action Required
Immediately: Billing team should review and implement the provided CPT Category II codes (3044F-3080F series) for all diabetic patients ages 18-75 to track comprehensive diabetes care components. Update billing software to include these quality measure codes for HbA1c testing, eye exams, nephropathy screening, and blood pressure control. Train providers to use appropriate codes when documenting care to help close HEDIS care gaps for Medicare Advantage and commercial plan members.