Updated 2025 HEDIS Provider Reference Guide

We recently made policy changes and clarifications to the 2025 HEDIS Provider Reference Guide in alignment with the National Committee for Quality Assurance (NCQA) HEDIS MY (Measure Year) 2025 Volume 2 Technical Update.

The following measures were updated:

• Asthma Medication Ratio (AMR)
  o Removed albuterol-budesonide as an asthma reliever medication
  o Revised the Asthma Controller Medications table
• Controlling High Blood Pressure (CBP)
  o Updated the required exclusions
• Statin Therapy for Patients with Cardiovascular Disease (SPC)
  o Updated prescription information in the High and Moderate Intensity Statin Medications table
• Eye Exam for Patients with Diabetes (EED)
  o Updated required exclusions and numerator
• Statin Therapy for Patients with Diabetes (SPD)
  o Updated prescription information in the High and Moderate Intensity Statin Medications table
• Transitions of Care (TRC)
  o Revised the hybrid specification for the Notification of Inpatient Admission and Receipt of Discharge Information indicators
• Breast Cancer Screening (BSC-E)
  o Updated the member age range for this measure from 50-74 years of age to 40-74 years of age
• Blood Pressure Control for Patients with Hypertension (BPC-E)
  o Updated exclusions and numerator compliance
• Adult Immunization Status (AIS-E)
  o Updated the numerator criteria of the herpes zoster vaccine
• Social Need Screening and Intervention (SNS-E)
  o Updated the definitions for the following: Housing instability, Homelessness and Housing inadequacy

Access the guide on the Quality Improvement page through our Provider Incentives webpage in prism (login required).