Product Lines:
Advantage MD, EHP, Priority Partners, and USFHP.

Eligible Population:
Members 18-75 years old as of December 31 of the measurement year.

Definition:
Members 18–75 years of age with diabetes (type 1 and type 2) whose blood pressure (BP) was adequately controlled (< 140/90) during the measurement year.

Note: Uses last BP of the year.

Continuous Enrollment:

• The measurement year.
  

Best Practice and Measure Tips

BP reading must be the last BP result performed within the measurement year. 

See CBP Measure for tips.

Measure Exclusions

Required Exclusions:

• Palliative Care
• Members in hospice or using hospice services anytime during the measurement year.
• Members who died any time during the measurement year.
• Frailty and Advanced Illness
• Living in Long Term Care

Measure Codes

• Diastolic Less than 80 
  • CPT-CAT-II: 3078F
• Diastolic 80-89 
  • CPT-CAT-II: 3079F
• Diastolic Greater than/Equal to 90 
  • CPT-CAT-II: 3080F
• Systolic Less than 130 
  • CPT-CAT-II: 3074F
• Systolic 130-139
  • CPT-CAT-II: 3075F
• Systolic Greater than/Equal to 140 
  • CPT-CAT-II: 3077F

Medication List: Diabetes Medications