Updated Guidance on HEDIS MY2025
Date: 08/05/25
The National Committee for Quality Assurance (NCQA) has provided updated guidance as part of the HEDIS MY25 Volume 2 Technical Update that were released March 31, 2025. The following table outlines the measures that have been updated by the NCQA, and the respective health plan provider materials on which the original measures were originally included. For the most updated HEDIS measurements and standards, visit www.ncqa.org.
| Measure | Document | Change |
|---|---|---|
| Asthma Medication Ratio (AMR) | Quick Reference Guide HEDIS MY 2025 | Remove "Albuterol budesonide" prescription from Asthma Reliever Medications grid. |
| Breast Cancer Screening (BCS-E) | HEDIS Adult Pocket Guide: 2025 Measurement Year | Change "(Females Age 50-74) to "(Members Age 40-74)." |
| Quick Reference Guide HEDIS MY 2025 | Change "Measure evaluates the percentage of members 50 to 74 years of age…” to "Measure evaluates the percentage of members 40 to 74 years of age…" | |
| Controlling High Blood Pressure (CBP) | HEDIS Adult Pocket Guide: 2025 Measurement Year | Remove "Telephone Visits" Best Practice. |
| Eye Exam for Patients with Diabetes (EED) | HEDIS Adult Pocket Guide: 2025 Measurement Year | Add the following to Best Practice: "All eye exams must have result." |
| Add the following to Codes: "Autonomous Eye Exam: 92229." | ||
| Quick Reference Guide HEDIS MY 2025 | Change Description from "Automated Eye Exam" to "Autonomous Eye Exam." | |
| Kidney Health Evaluation for Patients with DM (KED) | HEDIS Adult Pocket Guide: 2025 Measurement Year | Change "EGR" to "eGFR." |
| Social Needs Screening and Intervention (SNS-E) | Quick Reference Guide HEDIS MY 2025 | For the "Children’s Health Watch Housing Stability Vital Signs™" line, change the "Positive Finding LOINC Codes >3" to "Positive Finding LOINC Codes ≤ 2." |
| Statin Therapy for Patients with Cardiovascular Disease (SPC) | Quick Reference Guide HEDIS MY 2025 | Change "Lovastatin 40 mg" to "Lovastatin 40-60 mg." |
| Transitions of Care (TRC) | Quick Reference Guide HEDIS MY 2025 | Change "For this measure, medication reconciliation may be conducted by a prescribing practitioner, clinical pharmacist, physician assistant, or registered nurse." to "For this measure, medication reconciliation must be conducted by a prescribing practitioner, clinical pharmacist, physician assistant or registered nurse." |
For questions or concerns, contact your provider engagement account manager in your area or call Provider Services at:
- Iowa Total Care: 1-833-404-1061, Monday – Friday 7:30 a.m. - 6 p.m. CT.
- Ambetter: 1-833-919-3213, Monday - Friday 7 a.m. - 7 p.m. CT.
- Wellcare: 1-855-538-0454, Monday - Friday 8 a.m. - 8 p.m. CT.
Thank you for your partnership in serving our members.