Persistence of Beta-Blocker Treatment after a
Heart Attack (PBH)
HEDIS® Measurement Year 2021
Measure description: This measure captures the percentage of members 18 years of age and older
during the measurement year who were hospitalized and discharged from July 1 of the year prior to
the measurement year to June 30 of the measurement year with a diagnosis of AMI and who
received persistent beta-blocker treatment for six months after discharge.
Eligible population Strategies for increasing medication
Members 18 years and older as of December 31 of adherence
the measurement year. Compliance is measured • Advise patients who suddenly stopping
by at least 135 days of treatment with beta- medication can lead to complications such
blockers during the 180-day measurement as heart attack, increased hypertension, or
interval. This allows gaps in medication treatment increased anxiety.
of up to a total of 45 days during the 180-day • Develop a medication routine with each
measurement interval. patient if they are on multiple medications
that require them to be taken at different
Measure adherence times.
Adherence for the PBH measure is determined by • Utilize pill boxes or organizers.
the member remaining on their prescribed beta- • Advise patients to set up reminders and
blocker medications for six months following alarms for when medications are due.
discharge for a diagnosis of AMI. This is • Discuss potential side effects and ways to
determined by pharmacy claims data (the plan treat the side effects of medications.
will capture data each time the member fills their
prescription). New for some measures in
measurement year 2021: Telehealth
The medications the NCQA lists in the HEDIS
Be sure to bill the appropriate codes to match the
specifications are below. This is a general list and
telehealth visit that occurred.
should not replace the advice or care you provide
your patients regarding what is optimal to meet
their healthcare needs.
Beta-blocker medications
Description Prescription
Noncardioselecti Carvedilol Labetalol Nadolol Penbutolol
ve beta-blockers Pindolol Propranolol Timolol Sotalol
Cardioselective Acebutolol Atenolol Betaxolol Bisoprolol
beta-blockers Metoprolol Nebivolol
Antihypertensive Atenolol-chlorthalidone
combinations Bendroflumethiazide-nadolol
Bisoprolol-hydrochlorothiazide
Hydrochlorothiazide-metoprolol
Hydrochlorothiazide-propranolol
What You Can Do – Coding
• Synchronous telehealth visits: Requires
real-time interactive audio and video tele
communications. A measure specification
that is silent about telehealth includes
synchronous telehealth. This is because
tele-health is billed using standard CPT
and HCPCS codes for professional services
in conjunction with a telehealth modifier
and/or a telehealth POS code.
• Telephone visits: A measure will indicate
when telephone visits are eligible for use
by referencing the Telephone Visits Value
Set.
• Asynchronous e-visits: Sometimes referred
to as an e-visit or virtual check-in, is not
“real-time” but still requires two-way
interaction between the member and
provider.
Codes
Telehealth Modifier: 95, GT Telehealth POS: 02
Telephone Visit CPT: 98966-98968, 99441-99443
Online Assessment CPT: 989-98972, 99421
99423, 99444, 99458
Online Assessment HCPCS: G2010, G2012, G2061
G2063
Quality Measure Toolkit
AetnaBetterHealth.com/Virginia
VA-21-05-38 Aetna Better Health® of Virginia
