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HEDIS® Tip Sheet

Annual Preventative Visits for Adults (APV)

Measure Description

The percentage of attributed members ages 22-64 years of age who had at least one comprehensive well-care visit with a PCP or an OB/GYN practitioner during the measurement year.

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Notes

  • The denominator is all attributed members 22-64 years of age as of 12/31 of the measurement year.
  • The numerator is the number of attributed members 22-64 years of age who had at least one comprehensive well-care visit with a PCP or an OB/GYN practitioner during the measurement year.
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Exclusions

  • Services provided in an acute inpatient setting.
  • Members on hospice services during the measurement year.
  • Members who died during the measurement year.
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Best Practices

  • Educate patients and providers on the importance of annual preventive care visits and their role in supporting long-term health and early disease detection.
  • Schedule the patient's next preventive care visit before they leave their current appointment to promote continuity of care and reduce gaps in preventive services.
  • Simplify scheduling by promoting use of the patient portal for appointment booking, reminders, and access to health information. Consider offering self-scheduling options to improve convenience and patient engagement.
  • Train providers and staff to proactively identify and reach out to patients who are due or overdue for preventive care services.
  • Leverage EMR tools, including patient registries, reports, health maintenance reminders, and patient flags, to identify individuals in need of preventive services and follow-up.
  • Implement appointment reminder systems using phone calls, text messages, emails, or patient portal notifications to improve attendance and reduce missed appointments.
  • Reserve appointment availability for preventive care visits to improve access and accommodate patient scheduling needs.
  • Establish outreach workflows for patients who cancel or miss appointments to ensure timely rescheduling and completion of recommended preventive services.
  • Monitor preventive care performance regularly and utilize EMR reporting capabilities to identify care gaps, track outreach efforts, and measure improvement opportunities.
  • Ensure preventive care services are documented in structured EMR fields whenever possible to support quality reporting and supplemental data submission.
  • For facilities with low denominators, use MedeWorks to drill down and identify patient-level care gaps to drive interventions.

Coding:

This measure is identified with codes including, but not limited to: 99385-99387, 99395-99397.

Coding and Benefits Disclaimer

Providers and organizations must submit accurate and complete data in accordance with all billing, coding, and medical policy requirements. HEDIS guidance does not override official coding standards or guarantee reimbursement, as coverage is subject to applicable medical/coding policy and member-specific benefits.

Questions

Should you have specific coding or other questions related to the measure, please send your questions to BlueAlliance@bcbsnd.com.

NCQA Copyright Notice and Disclaimer
The HEDIS® measures and specifications were developed by and are owned by NCQA. The HEDIS measures and specifications are not clinical guidelines and do not establish a standard of medical care. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures and specifications. NCQA holds a copyright in these materials and can rescind or alter these materials at any time. These materials may not be modified by anyone other than NCQA. Use of the Rules for Allowable Adjustments of HEDIS to make permitted adjustments of the materials does not constitute a modification. Any commercial use and/or internal or external reproduction, distribution and publication must be approved by NCQA and are subject to a license at the discretion of NCQA. Any use of the materials to identify records or calculate measure results, for example, requires a custom license and may necessitate certification pursuant to NCQA’s Measure Certification Program. Reprinted with permission by NCQA. © [2025] NCQA, all rights reserved.

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Updated 8/28/2026