Use CPT II codes to boost HEDIS scores

May 22, 2024

Current Procedural Terminology Category II (CPT® II) codes simplify performance measure reporting, reduce the need for medical chart retrieval and abstraction, help close gaps in care, and improve Healthcare Effectiveness Data and Information Set (HEDIS®)* scores.

Providers who use CPT II codes receive fewer chart review requests and, on average, have higher HEDIS and Centers for Medicare & Medicaid Services Star Ratings.

Data capture methods

Providers have three main ways to capture HEDIS quality data.

CPT II codesSupplemental data feedsArcadia
Informational claim codes for tracking, reporting quality performance (preferred method)Automated data exchange between your electronic medical record (EMR) and Cigna HealthcareCigna Healthcare digital population health management tool
FastBidirectional or one-wayManual entry of quality care gaps
Efficient EMR interface

Learn more

Refer to the flyer Medicare Advantage HEDIS CPT II Codes.

*   HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

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