Hedis Well Child Visits: A Guide for Healthcare Providers

As a healthcare provider, it is essential to understand HEDIS metrics and guidelines to ensure that our patients receive the best possible care. In this article, we will provide an overview of the measures and billing codes related to well-child visits.

The first measure focuses on comprehensive well visits with a PCP or OB/GYN for children between ages 12-21 years. This includes billing codes such as 99383, 99384, 99385, 99393, 99394, and 99395. The goal is to ensure that young adults receive regular check-ups to monitor their health and prevent potential issues.

The second measure targets well-child visits for children between ages 3-6 years. This is crucial during this stage of development, as it allows healthcare providers to identify any potential developmental delays or concerns early on.

The third measure focuses on the percentage of children who have had six or more well-child visits with a PCP during their first 15 months of life. This is a critical period for infants, as they are rapidly developing and require regular check-ups to ensure proper growth and development.

It is essential for healthcare providers to understand HEDIS specifications and guidelines, as they provide a framework for measuring the quality of care provided to patients. By following these measures and guidelines, we can ensure that our patients receive the best possible care and that we are providing high-quality services to our community.

The American Academy of Pediatrics (AAP) has developed a toolkit called Bright Futures, which provides resources and tools to support healthcare providers in delivering high-quality well-child visits. The toolkit includes educational handouts for parents and patients, as well as guidelines for anticipatory guidance and reinforcing key messages.

In conclusion, HEDIS metrics are an essential tool for measuring the quality of care provided to patients. By understanding the measures and billing codes related to well-child visits, healthcare providers can ensure that their patients receive the best possible care. The Bright Futures toolkit is a valuable resource for healthcare providers, providing guidance on anticipatory guidance and reinforcing key messages.

Hedis well child visits