UOP: Use of Opioids at High Dosage
Percentage with cumulative MME ≥90 for ≥90 days. Star inverse measure (lower is better).
Measure description
Percentage with cumulative MME ≥90 for ≥90 days. Star inverse measure (lower is better).
Eligible population
Members on opioids
Performance drivers
CDC guideline + Star measure.
Documentation & PA strategy
MME cap at 90/day; document if exception (palliative, cancer, sickle cell, hospice).
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 UOP measure?
Percentage with cumulative MME ≥90 for ≥90 days. Star inverse measure (lower is better).
What drives performance on this measure?
CDC guideline + Star measure.
How should clinicians document for this measure?
MME cap at 90/day; document if exception (palliative, cancer, sickle cell, hospice).
What is the eligible population?
Members on opioids
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