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2025 Behavioral Health Follow-Up Measures Update

Date: 07/03/25

Overview

Measurement Year (MY) 2025 introduces several important updates to behavioral health follow-up measures, specifically for Follow-Up After Hospitalization for Mental Illness (FUH) and Follow-Up After Emergency Department Visit for Mental Illness (FUM). These updates aim to improve alignment, expand qualifying diagnoses, and increase collaboration of care.

Follow-Up After Hospitalization for Mental Illness (FUH)

Measure Description:

This measure tracks the percentage of discharges between January 1 and December 1 for members aged 6 and older who were hospitalized with:

  • A principal diagnosis of mental illness, or
  • Any diagnosis of intentional self-harm,
    and who received a follow-up mental health service.

Reported Rates:

  1. Follow-up within 30 days of discharge.
  2. Follow-up within 7 days of discharge.

Key 2025 Changes:

  • Expanded Denominator:
    • Intentional self-harm diagnoses now qualify regardless of diagnosis position on the inpatient discharge claim.
    • Inclusion of additional diagnoses such as phobia, anxiety disorders, and suicidal ideation.
  • Expanded Numerator:
    • Added primary care provider (PCP) visits with any mental health diagnosis.
    • Inclusion of peer support and residential treatment services as valid follow-up.
    • Increased flexibility in provider types and care settings to count as qualifying follow-up
      • Intensive outpatient programs (IOP)
      • Community mental health center (CMHC) visits
      • Electroconvulsive therapy (ECT)

Why Follow-Up Care Matters

Timely follow-up after hospitalization or Emergency Department (ED) visits for mental illness or self-harm is crucial. It supports a smoother transition back to daily life, improves treatment adherence, helps detect early warning signs, and addresses medication concerns.

The Psychiatric Collaborative Care Model promotes integration of behavioral health into primary care, enabling non-behavioral health providers to collaborate with psychiatric consultants to improve care outcomes.

Provider Tips for Improving Follow-Up Compliance

  • Offer flexible options: In-person, telehealth, virtual, and phone visits.
  • Engage patients & families: Use empathetic, nonjudgmental communication.
  • Proactively schedule follow-ups to meet 7- and 30-day requirements.
  • Coordinate care across behavioral and physical health disciplines.
  • Address social drivers of health and support health equity efforts.
  • Reinforce treatment plans and review medications for side effects.
  • Accurately code diagnoses and services and submit claims promptly.

Resources for Providers & Patients



Last Updated: 07/03/2025