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Provider News Digest

Follow-Up HEDIS Measures for Substance Use Disorders

Behavioral Health
Nov 28, 2025

The Healthcare Effectiveness Data and Information Set (HEDIS) is one of healthcare's most widely used performance improvement tools. Three HEDIS measures focus on follow-up care for substance use disorders. These measures are:

  1. FUI — Follow-Up After High-Intensity Care for Substance Use Disorder, which measures the percentage of substance use disorders (SUD) patients who had a follow-up visit after an acute inpatient stay, residential treatment, or detoxification. This measure's goal is to ensure timely transition to outpatient or continuing care after intensive treatment at: 
    • 7-Day Follow-Up (FUI-7) 
    • 30-Day Follow-Up (FUI-30)
       
  2. IET — Initiation and Engagement of Substance Use Disorder Treatment, which measures:
    • Initiation: A follow-up visit within 14 days of a new SUD diagnosis
    • Engagement: At least 2 additional visits 34 days after initiation The goal of this measure is to promote early and sustained treatment engagement for newly diagnosed individuals. 
       
  3. FUA —Follow-Up After Emergency Department (ED) Visit for Substance Use, which measures the percentage of ED visits with a principal diagnosis of SUD, or any diagnosis of drug overdose that had a  follow-up visit.  Using the same time frames as FUI (see #1 above), this measure's goal is to reduce relapse and improve outcomes by ensuring timely outpatient care after ED discharge. 

How Can Providers Ensure Timely Follow Up?

Encourage providers and staff to:

  • Offer telehealth and phone visits. 
  • Schedule the first visit within 7 days. 
  • Code substance-related diagnoses and visits correctly on claims. 
  • Partner with the Select Health and assess for peer support and care management referrals. 
  • Coordinate care between physical and mental health providers. 
  • Educate on relapse prevention and treatment options 

What Are Eligible Follow-Up Care Settings & Services for SUD?

Eligible care settings for SUD follow up include:

  • Telehealth, telephone, or virtual visit 
  • Outpatient visit 
  • Observation visit 
  • Intensive outpatient encounter or partial hospitalization 
  • Nonresidential SUD facility 
  • Community mental health center visit 
  • Residential (BH) Treatment Center (for FUI only) 
  • Acute and Nonacute Inpatient (for FUI and IET only)

Eligible care services for follow-up SUD care include: 

  • Opioid Treatment 
  • Substance Use Service 
  • Medication-Assisted Treatment for Alcohol or Opioid 
  • Peer support (for FUA only)