March 13, 2023
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioral health disorders affecting children, according to the (CDC). ADHD medication can help manage symptoms including hyperactivity, impulsiveness and inattention, according to the . The (NCQA) recommends that pediatricians with prescribing authority monitor children using ADHD medication to ensure it is prescribed and managed correctly.
Supporting Quality Care
- Initiation phase: One follow-up visit with a provider with prescribing authority within 30 days of the first prescription
- Continuation and maintenance phase: Two or more follow-up visits with a provider in the nine months (270 days) after the initiation phase. The child also remains on the ADHD medication for at least 210 days
Visits for both phases can be by telehealth when appropriate and depending on the member’s benefits.
For tips to close gaps in care for this measure, see our tip sheet.
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material, is not a guarantee that the service or treatment is a covered benefit and members should refer to their member contract or member guide for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.