NAA: Pharmacotherapy for Opioid Use Disorder
Percentage with 180+ days of buprenorphine, methadone, or naltrexone in measurement year.
Measure description
Percentage with 180+ days of buprenorphine, methadone, or naltrexone in measurement year.
Eligible population
Members with OUD diagnosis
Performance drivers
MOUD under-prescribed; CMS Star measure.
Documentation & PA strategy
Document OUD diagnosis (F11.2x). Buprenorphine PA simplified post-X-DEA. Methadone via OTP only.
Why HEDIS matters for prior authorization
Health plans align prior authorization criteria with HEDIS measures: documenting your patient meets the HEDIS definition often streamlines or eliminates PA hurdles. For Medicare Advantage in particular, plans are heavily incentivized via Star Ratings to push members and providers toward measure compliance, which translates into faster approvals for measure-aligned services.
Frequently asked questions
What does HEDIS measure NAA measure?
Percentage with 180+ days of buprenorphine, methadone, or naltrexone in measurement year.
What drives performance on this measure?
MOUD under-prescribed; CMS Star measure.
How should clinicians document for this measure?
Document OUD diagnosis (F11.2x). Buprenorphine PA simplified post-X-DEA. Methadone via OTP only.
What is the eligible population?
Members with OUD diagnosis
Streamline NAA workflow with ApprovalHelp
ApprovalHelp automates clinical PA, appeals, and HEDIS-aligned documentation. no setup fee.
Get started →Contact: hello@approvalhelp.com