HEDIS FMC quality measure: Follow-Up after Emergency Department Visit for for People With Multiple High-Risk Chronic Conditions.
Posted 10/05/26
What is the FMC measure?
The HEDIS Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC)
measure highlights the importance of timely follow-up care after an acute health care event. While a hospitalization or emergency department visit may address an immediate concern, follow-up care provides an opportunity to assess the patient’s current health status, review their treatment plan, identify ongoing needs, and help prevent future episodes.
Compliance with the FMC measure is a follow-up visit on the date of the ED visit through 7 days after the ED visit.
What counts toward the measure?
Several types of follow-up encounters may count toward the FMC measure, including, but not limited to, office visits, e-visits, virtual check-ins, transitional care management, and telephone visits. While a claim is generally the preferred method for providing evidence of closing the care gap, non-standard supplemental data may also be used to determine compliance.
Documenting telephone encounters.
To support appropriate documentation of telephone encounters, the template below outlines the key information that should be captured by designated clinical staff and reviewed and signed by a provider.
| Documentation element | What to include |
|---|---|
| Date of telephone encounter |
Must occur within the FMC 8-day window. Example: 08/28/2026 – Post-ED follow-up call |
| Reason for the call |
Explicitly identify that this is follow-up after the ED visit. Example: “RN contacted patient for follow-up after ED visit on 08/26/2026.” |
| Successful patient/caregiver contact |
Document that the patient or appropriate caregiver was actually reached. *A voicemail/attempted call alone generally should not be treated as a completed telephone visit. |
| Clinical discussion/assessment |
Document what was discussed regarding the ED visit and the patient's current status.
Key components include:
|
| Follow-up plan/action |
Document what was done as a result of the call:
|
| Return precautions | Document instructions regarding worsening symptoms/when to seek additional care. |
| Proper encounter/coding |
The telephone service needs to generate the appropriate claim/encounter evidence. Qualifying telephone codes include 98966–98968 and other telephone/telehealth codes in the FMC code set. |
