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HEDIS® Tip Sheet

Well-Child Visits First 15 Months (W30A)

Measure Description

The percentage of Members who had six or more well-child visits with a PCP (Primary Care Provider) on different dates of service on or before 15 months of age.

Either of the following meet criteria:

  • A well-care visit
  • An encounter for well-care, do not include laboratory claims
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Notes

  • Calculate the 15-month birthday as the child’s first birthday plus 90 days.
  • The well-child visits must occur with a Primary Care Provider (PCP), but the PCP does not have to be the practitioner or provider assigned to the child.
  • Well-Child visits must be at least 14 days apart to be counted.
  • Telehealth visits do not count as well-child visits
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Exclusions

  • Members in hospice during the measurement year.
  • Members who died during the measurement year.
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Best Practices

  • Encourage parents or guardians to establish care with a primary care provider and reinforce the importance of routine preventive visits.
  • Explain the value of screenings, anticipatory guidance, and counseling provided during each well-child visit.
  • Help parents or guardians understand why well-child visits are important for monitoring growth, development, and overall health.
  • Conduct outreach calls and/or send reminder letters to notify members when a well-child visit is needed.
  • Provide education about well-child visits during sick visits and complete the well-child visit when clinically appropriate.
  • Use reminder calls, text messages, or patient portal messages to help families keep scheduled appointments.
  • Encourage families to enroll in the patient portal, when available, to support communication and appointment management.
  • Schedule the next well-child visit before the family leaves the current appointment; consider having scheduling support available in the exam room.
  • Share educational resources that emphasize the importance and benefits of completing recommended well-child visits.

Well Care Codes







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.

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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