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2025 HEDIS Toolkit Addendum

Date: 06/16/25

The NCQA has provided new guidance as part of the HEDIS MY25 Volume 2 Technical Update that was released March 31, 2025. The following table outlines the measures that have been updated by the NCQA and the respective Sunflower 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

(AMR) Asthma Medication Ratio

Quick Reference Guide HEDIS MY 2025

Remove "Albuterol budesonide" prescription from Asthma Reliever Medications grid

(BCS-E) Breast Cancer Screening

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…"

(CBP) Controlling High Blood Pressure

HEDIS Adult Pocket Guide: 2025 Measurement Year

Remove "Telephone Visits" Best Practice

(EED) Eye Exam for Patients with Diabetes

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"

(KED) Kidney Health Evaluation for Patients with DM

HEDIS Adult Pocket Guide: 2025 Measurement Year

Change "EGR" to "eGFR"

(SNS-E) Social Needs Screening

and Intervention

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"

(SPC) Statin Therapy for Patients with Cardiovascular Disease

Quick Reference Guide HEDIS MY 2025

Change "Lovastatin 40 mg" to "Lovastatin 40-60 mg"

(TRC) Transitions of Care

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."

If you have questions about this bulletin or other provider resources, please contact your Provider Relations Representative or call us at the numbers below: