1 2025 UDS Manual Tables

HRSA Uniform Data System (UDS)

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Uniform Data System

OMB: 0915-0193

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Uniform Data System
2025 REPORTING TABLES
Health Center Data Reporting Requirements

Health Center Program

For Reports Due February 15, 2026

Bureau of Primary Health Care

Uniform Data System
Reporting Tables for 2025
Health Center Data

PUBLIC BURDEN STATEMENT
The Uniform Data System (UDS) provides consistent information about health centers including patient characteristics, services provided, clinical processes
and health outcomes, patients’ use of services, costs, and revenues. It is the source of unduplicated data for the entire scope of services included in the grant
or designation for the calendar year. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a currently valid Office of Management and Budget (OMB) control number. The OMB control number for this project is 0915-0193 and it is valid
until 04/30/2026. This information collection is mandatory under the Health Center Program authorized by section 330 of the Public Health Service (PHS)
Act (42 U.S.C. 254b). Public reporting burden for this collection of information is estimated to average 238 hours per response, including the time for
reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Health Resources and Services
Administration (HRSA) Reports Clearance Officer, 5600 Fishers Lane, Room 14N136B, Rockville, Maryland, 20857 or paperwork@hrsa.gov.
DISCLAIMER
“This publication lists non-federal resources to provide additional information to consumers. Neither the U.S. Department of Health and Human Services
(HHS) nor the Health Resources and Services Administration (HRSA) has formally approved the non-federal resources in this manual. Listing these is not
an endorsement by HHS or HRSA.”

Bureau of Primary Health Care

Uniform Data System Reporting
Tables
For Calendar Year 2025 UDS Data

For help contact: 866-837-4357 (866-UDS-HELP), BPHC Contact Form,
https://bphc.hrsa.gov/datareporting/reporting/index.html, or udshelp330@bphcdata.net
Health Resources and Services Administration
Bureau of Primary Health Care
5600 Fishers Lane, Rockville, Maryland 20857

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2025 Uniform Data System Reporting Tables
2025 Uniform Data System Reporting Tables
Content
Patients by ZIP Code Table .............................. 5
Table 3A: Patients by Age and by Sex ............. 6
Table 3B: Demographic Characteristics ........... 7
Table 4: Selected Patient Characteristics.......... 9
Table 4: Selected Patient Characteristics
(continued)...................................................... 10
Table 5: Staffing and Utilization .................... 11
Table 5: Staffing and Utilization (continued) . 12
Table 5: Selected Service Detail Addendum .. 13
Table 6A: Selected Diagnoses and Services
Rendered ......................................................... 14
Selected Diagnoses ......................................... 14
Selected Services Rendered ............................ 16
Sources of Codes ............................................ 18

4

Table 6B: Quality of Care Measures .............. 19
Table 7: Health Outcomes .............................. 23
Table 8A: Financial Costs .............................. 35
Table 9D: Patient Service Revenue ................ 37
Table 9E: Other Revenues.............................. 39
Appendix D: Health Center Health Information
Technology (Health IT) Capabilities .............. 40
Introduction .................................................... 40
Questions ........................................................ 40
Appendix E: Other Data Elements ................. 46
Introduction .................................................... 46
Questions ........................................................ 46
Appendix F: Workforce ................................... 49
Introduction .................................................... 49
Questions ........................................................ 49

2025 UDS REPORTING TABLES | Table of Contents

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PATIENTS BY ZIP CODE TABLE

Calendar Year: January 1, 2025, through December 31, 2025

None/
Uninsured
(b)

ZIP Code
(a)

Medicaid/
CHIP/Other Public
(c)

Medicare
(d)

Private
(e)

Total
Patients (f)

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[Blank for demonstration]

[Blank for demonstration]

[Blank for demonstration]

Other ZIP Codes
Unknown Residence
Total

Note: The actual output from the EHBs will display ZIP codes entered by the health center in Column A.

5

2025 UDS REPORTING TABLES | Instructions for ZIP Codes

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TABLE 3A: PATIENTS BY AGE AND BY SEX
Calendar Year: January 1, 2025, through December 31, 2025

Line

Age Groups

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39

Under age 1
Age 1
Age 2
Age 3
Age 4
Age 5
Age 6
Age 7
Age 8
Age 9
Age 10
Age 11
Age 12
Age 13
Age 14
Age 15
Age 16
Age 17
Age 18
Age 19
Age 20
Age 21
Age 22
Age 23
Age 24
Ages 25–29
Ages 30–34
Ages 35–39
Ages 40–44
Ages 45–49
Ages 50–54
Ages 55–59
Ages 60–64
Ages 65–69
Ages 70–74
Ages 75–79
Ages 80–84
Age 85 and over

6

Male Patients
(a)

Total Patients
(Sum of Lines 1–38)

Female Patients
(b)





























































































































































2025 UDS REPORTING TABLES | Instructions for Tables 3A and 3B

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TABLE 3B: DEMOGRAPHIC CHARACTERISTICS
Calendar Year: January 1, 2025, through December 31, 2025

blank

Patients by Race and
Hispanic, Latino/a, or
Spanish Ethnicity

Line

Patients by Race

1a
1b
1c
1d
1e
1f
1g

Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Total Asian (Sum Lines
1a+1b+1c+1d+1e+1f+1g)
Native Hawaiian
Other Pacific Islander
Guamanian or Chamorro
Samoan
Total Native
Hawaiian/Other Pacific
Islander
(Sum Lines 2a+2b+2c+2d)
Black or African American
American Indian/Alaska
Native
White
More than one race
Unreported/Chose not to
disclose race
Total Patients
(Sum of Lines 1 + 2 + 3 to
7)

1
2a
2b
2c
2d
2
3
4
5
6
7
8

7

blank
Yes,
Mexican,
Mexican
American,
Chicano/a
(a1)

Yes,
Puerto
Rican
(a2)

Yes,
Cuban
(a3)





































































































Yes,
Another
Hispanic,
Latino/a, or
Spanish
Origin
(a4)










Yes,
Hispanic,
Latino/a,
Spanish
Origin,
Combined
(a5)

Total Hispanic,
Latino/a, or
Spanish Origin
(a) (Sum
Columns a1 +
a2 + a3 + a4 +
a5)


















































2025 UDS REPORTING TABLES | Instructions for Tables 3A and 3B



















blank

blank

blank

Not
Hispanic,
Latino/a,
or
Spanish
Origin
(b)

Unreported
/ Chose Not
to Disclose
Ethnicity
(c)

Total
(d)
(Sum
Columns
a+b+c)














































































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Line

Patients Best Served in a Language Other than English

12

Patients Best Served in a Language Other than English

8

Number
(a)


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TABLE 4: SELECTED PATIENT CHARACTERISTICS
Calendar Year: January 1, 2025, through December 31, 2025

Line

Income as Percentage of Poverty Guideline

1
2
3
4
5
6

100% and below
101–150%
151–200%
Over 200%
Unknown

Line

Primary Third-Party Medical Insurance

7
8a
8b
8
9a
9
10a
10b
10
11
12

TOTAL (Sum of Lines 1–5)

Medicaid (Title XIX)
CHIP Medicaid

Total Medicaid (Line 8a + 8b)
Dually Eligible (Medicare and Medicaid)
Medicare (Inclusive of dually eligible and other Title
XVIII beneficiaries)
Other Public Insurance (Non-CHIP) (specify___)
Other Public Insurance CHIP
Total Public Insurance (Line 10a + 10b)
Private Insurance
TOTAL (Sum of Lines 7 + 8 + 9 +10 +11)

Line

Managed Care Utilization

13a
13b

Capitated Member Months
Fee-for-service Member Months
Total Member Months
(Sum of Lines 13a + 13b)

13c

9

None/Uninsured

Medicaid
(a)

Number of Patients
(a)






0–17 years old
(a)

18 and older
(b)













































Medicare
(b)

Other Public
Including
Non-Medicaid
CHIP
(c)

Private
(d)

TOTAL
(e)































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TABLE 4: SELECTED PATIENT CHARACTERISTICS (CONTINUED)
Calendar Year: January 1, 2025, through December 31, 2025

Line

Special Medically Underserved Populations

14

Migratory Agricultural Workers or Their Family Members (330g awardees
only)
Seasonal Agricultural Workers or Their Family Members (330g awardees
only)
Total Migratory and Seasonal Agricultural Workers or Their Family
Members
(All health centers report this line)
Homeless Shelter (330h awardees only)
Transitional (330h awardees only)
Doubling Up (330h awardees only)
Street (330h awardees only)
Permanent Supportive Housing (330h awardees only)
Other (330h awardees only)
Unknown (330h awardees only)
Total Homeless Population (All health centers report this line)
Total School-Based Service Site Patients
(All health centers report this line)
Total Veterans (All health centers report this line)
Total Residents of Public Housing 1
(All health centers report this line)

15
16
17
18
19
20
21a
21
22
23
24
25
26

1

Number of Patients
(a)
















Residents of public housing refers to patients who are served at a health center located in or immediately accessible to a public housing site.

10

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TABLE 5: STAFFING AND UTILIZATION
Calendar Year: January 1, 2025, through December 31, 2025

Line

Personnel by Major Service Category

1
2
3
4
5
7
8
9a
9b
10
10a
11
12
13
14
15

Family Physicians
General Practitioners
Internists
Obstetrician/Gynecologists
Pediatricians
Other Specialty Physicians
Total Physicians (Lines 1–7)
Nurse Practitioners
Physician Assistants
Certified Nurse Midwives
Total NPs, PAs, and CNMs (Lines 9a–10)
Nurses
Other Medical Personnel
Laboratory Personnel
X-ray Personnel
Total Medical Care Services (Lines 8 + 10a–
14)
Dentists
Dental Hygienists
Dental Therapists
Other Dental Personnel
Total Dental Services (Lines 16–18)
Psychiatrists
Licensed Clinical Psychologists
Licensed Clinical Social Workers
Other Licensed Mental Health Providers
Other Mental Health Personnel
Total Mental Health Services (Lines 20a–c)
Substance Use Disorder Services

16
17
17a
18
19
20a
20a1
20a2
20b
20c
20
21
22

•
•
•
•
•
•

•
•

11

Other Professional Services
Audiologists
Chiropractors
Community and Behavioral Health
Aides/Practitioners (CHA/Ps and
BHA/Ps)
Podiatrists
Registered Dieticians, including
Dieticians and Nutritionists
Therapists, including Massage,
Occupational, Physical, Respiratory,
and Speech Therapists and Speech
Pathologists
Traditional Medicine Providers,
including Acupuncturists and
Naturopaths
Other professional services
(specify___)

FTEs (a)

Clinic Visits
(b)

Virtual
Visits (b2)

Patients (c)









































































































































































































































2025 UDS REPORTING TABLES | Instructions for Table 5

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TABLE 5: STAFFING AND UTILIZATION (CONTINUED)
Calendar Year: January 1, 2025, through December 31, 2025

Line

Personnel by Major Service Category

22a
22b
22c
22d
23a
23b
23c
23d
23
24
25
26
27
27a
27b
27c
28
29
29a

Ophthalmologists
Optometrists
Other Vision Care Personnel
Total Vision Services (Lines 22a–c)
Pharmacists
Clinical Pharmacists
Pharmacy Technicians
Other Pharmacy Personnel
Pharmacy Personnel (Lines 23a–d)
Case Managers
Health Education Specialists
Outreach Workers
Transportation Personnel
Eligibility Assistance Workers
Interpretation Personnel
Community Health Workers
Other Enabling Services (specify___)
Total Enabling Services (Lines 24–28)
Other Programs and Services
Personnel for these programs:
• Adult, elderly, and youth programs, such
as ADHC, child care, PACE
• Basic needs, such as shelters/housing,
food, and clothing
• Employment, vocational, AmeriCorps or
other job training programs
• Fitness or exercise programs
• Head Start or Healthy Start
• Public/Retail pharmacies
• Research
• Support group services
• WIC
• Other programs and services (specify___)
Quality Improvement Personnel
Management and Support Personnel
Fiscal and Billing Personnel
IT Personnel
Facility Personnel
Patient Support Personnel
Total Facility and Non-Clinical Support
Personnel (Lines 30a–32)
Grand Total (Lines
15+19+20+21+22+22d+23+29+29a+29b+33)

29b
30a
30b
30c
31
32
33
34

12

FTEs (a)

Clinic Visits
(b)











Virtual
Visits (b2)

Patients (c)





























































































































































































2025 UDS REPORTING TABLES | Instructions for Table 5







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TABLE 5: SELECTED SERVICE DETAIL ADDENDUM
Calendar Year: January 1, 2025, through December 31, 2025

Line
20a01
20a02
20a03
20a04
Line
21a
21b
21c
21d
21e
21f
21g
21h

13

Personnel by Major Service Category:
Mental Health Service Detail
Physicians (other than Psychiatrists)
Nurse Practitioners
Physician Assistants
Certified Nurse Midwives
Personnel by Major Service Category:
Substance Use Disorder Detail
Physicians (other than Psychiatrists)
Nurse Practitioners (Medical)
Physician Assistants
Certified Nurse Midwives
Psychiatrists
Licensed Clinical Psychologists
Licensed Clinical Social Workers
Other Licensed Mental Health Providers

Personnel
(a1)

Clinic Visits
(b)



















Personnel
(a1)

2025 UDS REPORTING TABLES | Instructions for Table 5





Clinic Visits
(b)









Virtual
Visits (b2)

Patients (c)





























Virtual
Visits (b2)

Patients (c)

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TABLE 6A: SELECTED DIAGNOSES AND SERVICES RENDERED
Calendar Year: January 1, 2025, through December 31, 2025

SELECTED DIAGNOSES
Line
Selected Infectious and Parasitic Disease

1–2
3
4

Diagnostic Category
Selected Infectious and
Parasitic Diseases
Symptomatic/Asymptomatic
human immunodeficiency
virus (HIV)
Tuberculosis

4a

Sexually transmitted
infections (gonococcal
infections and venereal
diseases)
Hepatitis B

4b

Hepatitis C

4c

Novel coronavirus (SARSCoV-2) disease
Long COVID

4d
Selected Diseases of the Respiratory System

5

Selected Diseases of the
Respiratory System
Asthma

6

Chronic lower respiratory
diseases

6a

Respiratory conditions
related to COVID-19

Selected Other Medical
Conditions

Selected Other Medical
Conditions
Abnormal breast findings,
female

7

8

Abnormal cervical findings

9

Diabetes mellitus

14

Applicable ICD-10-CM Code or Value Set
Object Identifier (OID)

Number of Visits
by Diagnosis
Regardless of
Primacy (a)

Number of
Patients with
Diagnosis (b)

Selected Infectious and Parasitic Diseases

Selected Infectious and Parasitic Diseases

Selected Infectious and Parasitic
Diseases

ICD-10: B20, B97.35, O98.7-, Z21
OID:
2.16.840.1.113883.3.464.1003.120.12.1003
ICD-10: A15- through A19-, B90-, J65,
O98.0-, P37.0
OID: 2.16.840.1.113762.1.4.1146.451
ICD-10: A50- through A64-, A69.0, A69.1,
A69.8, A69.9
OID:
2.16.840.1.113883.3.464.1003.112.11.1003
ICD-10: B16.0 through B16.2, B16.9,
B18.0, B18.1, B19.1OID: 2.16.840.1.113883.3.67.1.101.1.271
ICD-10: B17.1-, B18.2, B19.2OID: 2.16.840.1.113762.1.4.1222.30
ICD-10: U07.1
OID: 2.16.840.1.113762.1.4.1248.139
ICD-10: U09, U09.9
OID: 2.16.840.1.113762.1.4.1178.98





























Selected Diseases of the Respiratory System

Selected Diseases of the Respiratory System

Selected Diseases of the
Respiratory System

ICD-10: J45OID: 2.16.840.1.113883.3.526.2.60
ICD-10: J40 (count J40 only when code
U07.1 is not present), J41- through J44-,
J47-, J4AICD-10: J12.82, J12.89, J20.8, J40, J22,
J98.8, J80 (count codes listed only when
code U07.1 is also present)
OID: 2.16.840.1.113762.1.4.1029.374
Selected Other Medical Conditions













Selected Other Medical Conditions

Selected Other Medical Conditions

ICD-10: C50.01-, C50.11-, C50.21-, C50.31, C50.41-, C50.51-, C50.61-, C50.81-,
C50.91-, C79.81, D05-, D24.-, D48.6-,
D49.3, N60- through N65-, R92ICD-10: C53-, C79.82, D06-, N87.0, N87.1,
N87.9, R87.61- (exclude R87.615 and
R87.616), R87.629, R87.810, R87.820
ICD-10: E08- through E13-, O24- (exclude
O24.4-)
OID: 2.16.840.1.113762.1.4.1219.35













2025 UDS REPORTING TABLES | Instructions for Table 6A

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Line

Diagnostic Category

10

Heart disease (selected)

11

Hypertension

12

Contact dermatitis and other
eczema

13

Dehydration

14

Exposure to heat or cold

14a

Overweight and obesity

Selected Childhood
Conditions (limited to
ages 0 thru 17)

Selected Childhood
Conditions (limited to ages
0 through 17)
Otitis media and Eustachian
tube disorders
Selected perinatal/neonatal
medical conditions

15
16
17

Selected Mental Health and Substance Abuse
Conditions

18
19
19a
20a
20b
20c

15

Lack of expected normal
physiological development
(such as delayed milestone,
failure to gain weight,
failure to thrive); nutritional
deficiencies in children
only. Does not include
sexual or mental
development.
Selected Mental Health
Conditions, Substance Use
Disorders, and
Exploitations
Alcohol-related disorders
Other substance-related
disorders (excluding
tobacco use disorders)
Tobacco use disorder
Depression and other mood
disorders
Anxiety disorders, including
post-traumatic stress
disorder (PTSD)
Attention deficit and
disruptive behavior
disorders

Applicable ICD-10-CM Code or Value Set
Object Identifier (OID)

Number of Visits
by Diagnosis
Regardless of
Primacy (a)

Number of
Patients with
Diagnosis (b)

ICD-10: I01-, I02- (exclude I02.9), I20through I25-, I27-, I28-, I30- through I52-,
Q24ICD-10: I10- through I16-, O10-, O11OID: 2.16.840.1.113762.1.4.1222.1547
(includes all codes other than O11-)
ICD-10: H01.13-, L20.89, L23- through
L25-, L30- (exclude L30.1, L30.3, L30.4,
L30.5)
ICD-10: E86-

















ICD-10: T33-, T34-, T67-, T68-, T69-, W92, W93-, X30-, X31-, X32ICD-10: E66-, Z68- (exclude Z68.1, Z68.20
through Z68.24, Z68.51, Z68.52)
OID: 2.16.840.1.113762.1.4.1222.35
(includes all E66- codes except E66.3)









Selected Childhood Conditions (limited to ages 0 thru 17)

Selected Childhood Conditions (limited to
ages 0 thru 17)

Selected Childhood Conditions
(limited to ages 0 thru 17)

ICD-10: H65- through H69-, H72-





ICD-10: A33, P19-, P22- through P29(exclude P29.3-), P35- through P96- (exclude
P54-, P91.6-, P92-, P96.81), Q86ICD-10: E40- through E46-, E50- through
E63-, P92-, R62- (exclude R62.7), R63.3(exclude R63.39)









Selected Mental Health and Substance use Conditions

Selected Mental Health and Substance use
Conditions

Selected Mental Health and
Substance use Conditions

ICD-10: F10-, G62.1, K70-, O99.31ICD-10: F11- through F19- (exclude F17-),
G62.0, O99.32-









ICD-10: F17-, O99.33-, Z72.0
ICD-10: F30- through F39-









ICD-10: F06.4, F40- through F42-, F43.0,
F43.1-, F43.8-, F93.0





ICD-10: F90- through F91-





2025 UDS REPORTING TABLES | Instructions for Table 6A

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Line

Diagnostic Category

20d

Other mental disorders,
excluding drug or alcohol
dependence

20e

Human trafficking

20f

Intimate partner violence

Applicable ICD-10-CM Code or Value Set
Object Identifier (OID)
ICD-10: F01- through F09- (exclude F06.4),
F20- through F29-, F43- through F48(exclude F43.0- and F43.1-), F50- through
F99- (exclude F55-, F84.2, F90-, F91-,
F93.0, F98-), O99.34-, R45.1, R45.2, R45.5,
R45.6, R45.7, R45.81, R45.82, R48.0
ICD-10: T74.5- through T74.6-, T76.5through T76.6-, Z04.81, Z04.82, Z62.813,
Z91.42
ICD-10: T74.11-, T74.21-, T74.31-, Z69.11

SELECTED SERVICES RENDERED
Line

Service Category

21

Selected Diagnostic Tests/
Screening/Preventive
Services
HIV test

21a

Hepatitis B test

21b

Hepatitis C test

21c

Novel coronavirus (SARSCoV-2) diagnostic test

21d

Novel coronavirus (SARSCoV-2) antibody test

21e

Pre-Exposure Prophylaxis
(PrEP)-associated
prescribing and
management
Mammogram

Selected Diagnostic
Tests/Screening/Preventive
Services

22

16

Applicable ICD-10-CM, CPT-4/PLA, or
HCPCS Code

Number of Visits
by Diagnosis
Regardless of
Primacy (a)

Number of
Patients with
Diagnosis (b)













Number of Visits
(a)

Number of
Patients (b)

Selected Diagnostic Tests/Screening/Preventive Services

Selected Diagnostic
Tests/Screening/Preventive Services

Selected Diagnostic
Tests/Screening/Preventive
Services

CPT-4: 86689, 86701 through 86703, 87389
through 87391, 87534 through 87539, 87806
HCPCS: G0432 through G0435, G0475
OID: 2.16.840.1.113762.1.4.1056.50
CPT-4: 80074, 86704 through 86707,
87340, 87341, 87350, 87467, 87912
HCPCS: G0499
CPT-4: 80074, 86803, 86804, 87520
through 87522, 87902
HCPCS: G0472
CPT-4: 87426, 87428, 87635, 87636, 87637,
87811
HCPCS: U0001, U0002
CPT PLA: 0202U, 0223U, 0225U, 0240U,
0241U
ICD-10: Z01.84
CPT-4: 86318, 86328, 86408, 86409, 86413,
86769
CPT PLA: 0224U, 0226U
ICD-10: Z29.81

























ICD-10: Z12.31
CPT-4: 77061, 77062, 77063, 77065, 77066,
77067
HCPCS: G0279





2025 UDS REPORTING TABLES | Instructions for Table 6A

UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM
Line

Service Category

23

Pap test

24

Selected immunizations:
hepatitis A; haemophilus
influenzae B (HiB);
pneumococcal, diphtheria,
tetanus, pertussis (DTaP)
(DTP) (DT); measles,
mumps, rubella (MMR);
poliovirus; varicella;
hepatitis B
Seasonal flu vaccine

24a

24b
25
26

26a
26b
26c
26c2
26c3
26d
26e
26f

17

Coronavirus (SARS-CoV2) vaccine
Contraceptive management
Health supervision of infant
or child (ages 0 through 11)
Childhood lead test
screening (9 to 72 months)
Screening, Brief
Intervention, and Referral to
Treatment (SBIRT)
Smoke and tobacco use
cessation counseling
Tobacco use cessation
pharmacotherapies
Medications for opioid use
disorder (MOUD)
Comprehensive and
intermediate eye exams
Childhood development
screenings and evaluations
Alzheimer’s disease and
related dementias (ADRD)
screening

Applicable ICD-10-CM, CPT-4/PLA, or
HCPCS Code
ICD-10: R87.619, R87.629, Z01.41-,
Z01.42, Z12.4 (exclude Z01.411 and
Z01.419)
CPT-4: 88141 through 88153, 88155, 88164
through 88167, 88174, 88175
HCPCS: G0123, G0143, G0144, G0145,
G0147, G0148, P3000
CPT-4: 90371, 90389, 90396, 90665, 90669,
90670, 90671, 90677, 90682, 90684, 90696,
90698, 90700, 90701, 90702, 90703, 90704,
90705, 90706, 90707, 90708, 90710, 90712,
90713, 90714, 90715, 90716, 90720, 90721,
90723, 90725, 90730, 90731, 90732, 90737,
90739, 90740, 90743, 90744, 90745, 90746,
90747, 90748, 90759

Number of Visits
(a)

Number of
Patients (b)









CPT-4: 90630, 90632, 90633, 90634, 90636,
90644, 90645, 90646, 90647, 90648, 90653,
90654, 90656, 90657, 90658, 90659, 90660,
90661, 90662, 90663, 90664, 90666, 90668,
90672, 90673, 90674, 90685, 90686, 90687,
90688, 90694, 90724, 90756
CPT-4: 91300 through 91322









ICD-10: Z30ICD-10: Z00.1-, Z76.1. Z76.2
CPT-4: 99381 through 99383, 99391
through 99393









ICD-10: Z13.88
CPT-4: 83655
CPT-4: 99408, 99409
HCPCS: G0396, G0397, G0443, H0050









ICD-10: Z71.6
CPT-4: 99406, 99407
HCPCS: G9906
OID: 2.16.840.1.113883.3.526.3.1190









OID: 2.16.840.1.113762.1.4.1046.269





CPT-4: 92002, 92004, 92012, 92014





ICD-10: Z13.4CPT-4: 96110, 96112, 96113, 96127
CPT-4: 99483
OID: 2.16.840.1.113883.3.526.3.1006









2025 UDS REPORTING TABLES | Instructions for Table 6A

UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM
Line
Selected Dental
Services

Service Category
Selected Dental Services

27
28

Emergency services
Oral exams

29
30
31

Prophylaxis—adult or child
Sealants
Fluoride treatment—adult or
child
Restorative services
Oral surgery (extractions
and other surgical
procedures)
Rehabilitative services
(Endo, Perio, Prostho,
Ortho)

32
33
34

Applicable ADA Code

Number of Visits
(a)

Number of
Patients (b)

Selected Dental Services

Selected Dental Services

Selected Dental
Services

CDT: D0140, D9110
CDT: D0120, D0145, D0150, D0160,
D0170, D0171, D0180
CDT: D1110, D1120
CDT: D1351
CDT: D1206, D1208
CPT-4: 99188
CDT: D21xx through D29xx
CDT: D7xxx





























CDT: D3xxx, D4xxx, D5xxx, D6xxx,
D8xxx





SOURCES OF CODES
Code System
ICD-10-CM
CPT
Code on Dental Procedures and
Nomenclature (CDT)
CVX
HCPCS
Value Sets

Primary Source
National Center for Health Statistics (NCHS)
American Medical Association (AMA)
American Dental Association (ADA)

Secondary Source
ICD10Data.com
CMS


CDC Vaccine Administered Code Set (CVX)
CMS
National Library of Medicine Value Set Authority Center


HCPCSData.com


Note: “X” in a code denotes any number, including the absence of a number in that place. Dashes (-) in a code
indicate that additional characters are required. ICD-10-CM codes all have at least four digits. These codes are not
intended to show whether or not a code is billable. Instead, they are used to point out that other codes in the series
are to be considered.

18

2025 UDS REPORTING TABLES | Instructions for Table 6A

UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM

TABLE 6B: QUALITY OF CARE MEASURES
Calendar Year: January 1, 2025, through December 31, 2025

0

Prenatal Care Provided by Referral Only (Check if Yes)

[blank for demonstration]

Section A—Age Categories for Prenatal Care Patients:
Demographic Characteristics of Prenatal Care Patients

Line
1
2
3
4
5
6

Age
Less than 15 years
Ages 15–19
Ages 20–24
Ages 25–44
Ages 45 and over

Number of Patients (a)

[blank for demonstration]
[blank for demonstration]
[blank for demonstration]
[blank for demonstration]
[blank for demonstration]

Total Patients (Sum of Lines 1–5)

[blank for demonstration]

Section B—Early Entry into Prenatal Care

Line

Early Entry into Prenatal Care

7
8
9

First Trimester
Second Trimester
Third Trimester

Patients Having First Visit with
Health Center (a)
[blank for demonstration]
[blank for demonstration]
[blank for demonstration]

Patients Having First Visit with
Another Provider (b)
[blank for demonstration]
[blank for demonstration]
[blank for demonstration]

Section C—Childhood Immunization Status

Line

Childhood Immunization Status

10

MEASURE: Percentage of children 2
years of age who received ageappropriate vaccines by their 2nd
birthday

Total Patients with
2nd Birthday (a)
[blank for demonstration]

Number of
Records Reviewed
(b)

[blank for demonstration]

Number of Patients
Immunized (c)
[blank for demonstration]

Section D—Cervical and Breast Cancer Screening

Line

Cervical Cancer Screening

11

MEASURE: Percentage of women
24–64 years of age who were
screened for cervical cancer

Line

Breast Cancer Screening

11a

MEASURE: Percentage of women
52–74 years of age who had a
mammogram to screen for breast
cancer

Total Female Patients
Aged 24 through 64 (a)
[blank for demonstration]

Total Female Patients
Aged 52 through 74 (a)
[blank for demonstration]

Number of
Records Reviewed
(b)

[blank for
demonstration]

Number of
Records Reviewed
(b)

[blank for
demonstration]

Number of Patients
Tested (c)
[blank for demonstration]

Number of Patients
with Mammogram (c)
[blank for demonstration]

Section E—Weight Assessment and Counseling for Nutrition and Physical Activity of Children/Adolescents

Line
12

19

Weight Assessment and Counseling
for Nutrition and Physical Activity
for Children/Adolescents
MEASURE: Percentage of patients
3–17 years of age with a BMI
percentile and counseling on nutrition
and physical activity documented

Total Patients Aged 3
through 17 (a)
[blank for demonstration]

Number of
Records Reviewed
(b)

[blank for
demonstration]

2025 UDS REPORTING TABLES | Instructions for Table 6B

Number of Patients
with Counseling and
BMI Documented (c)

[blank for demonstration]

UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM
Section F—Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Line
13

Preventive Care and Screening:
Body Mass Index (BMI) Screening
and Follow-Up Plan
MEASURE: Percentage of patients
18 years of age and older with (1)
BMI documented and (2) follow-up
plan documented if BMI is outside
normal parameters

Total Patients Aged 18
and Older (a)

Number of
Records Reviewed
(b)

[blank for demonstration]

[blank for demonstration]

Number of Patients
with BMI Charted
and Follow-Up Plan
Documented as
Appropriate (c)

[blank for demonstration]

Section G—Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Line
14a

Preventive Care and Screening:
Tobacco Use: Screening and
Cessation Intervention
MEASURE: Percentage of patients
aged 12 years of age and older who
(1) were screened for tobacco use one
or more times during the
measurement period, and (2) if
identified to be a tobacco user
received cessation counseling
intervention

Total Patients Aged 12
and Older (a)
[blank for demonstration]

Number of
Records Reviewed
(b)
[blank for
demonstration]

Number of Patients
Assessed for Tobacco
Use and Provided
Intervention if a
Tobacco User (c)

[blank for demonstration]

Section H—Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

Line

17a

Statin Therapy for the Prevention
and Treatment of Cardiovascular
Disease
MEASURE: Percentage of patients at
high risk of cardiovascular events
who were prescribed or were on statin
therapy

Total Patients at High
Risk of Cardiovascular
Events (a)

[blank for demonstration]

Number of
Records Reviewed
(b)

[blank for
demonstration]

Number of Patients
Prescribed or On
Statin Therapy (c)

[blank for demonstration]

Section I—Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet

Line

Ischemic Vascular Disease (IVD):
Use of Aspirin or Another
Antiplatelet

18

MEASURE: Percentage of patients
18 years of age and older with a
diagnosis of IVD or AMI, CABG, or
PCI procedure with aspirin or another
antiplatelet

20

Total Patients Aged 18
and Older with IVD
Diagnosis or AMI,
CABG, or PCI
Procedure (a)

[blank for demonstration]

Number of
Records Reviewed
(b)
[blank for
demonstration]

2025 UDS REPORTING TABLES | Instructions for Table 6B

Number of Patients
with Documentation
of Aspirin or Other
Antiplatelet Therapy
(c)

[blank for demonstration]

UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM
Section J—Colorectal Cancer Screening

Line

Colorectal Cancer Screening

19

MEASURE: Percentage of patients
46 through 75 years of age who had
appropriate screening for colorectal
cancer

Total Patients Aged 46
through 75 (a)

Number of
Records Reviewed
(b)

[blank for
demonstration]

[blank for
demonstration]

Number of Patients
with Appropriate
Screening for
Colorectal Cancer (c)
[blank for
demonstration]

Section K—HIV Measures

Total Patients First
Diagnosed with HIV
(a)

Line

HIV Linkage to Care

20

MEASURE: Percentage of patients
whose first-ever HIV diagnosis was
made by health center personnel
between December 1 of the prior year
and November 30 of the measurement
period and who were seen for followup treatment within 30 days of that
first-ever diagnosis

Line

HIV Screening

20a

MEASURE: Percentage of patients
15 through 65 years of age who were
tested for HIV when within age range

[blank for demonstration]

Total Patients Aged 15
through 65 (a)
[blank for demonstration]

Number of
Records Reviewed
(b)
[blank for
demonstration]

Number of
Records Reviewed
(b)

[blank for
demonstration]

Number of Patients
Seen Within 30 Days
of First Diagnosis of
HIV (c)

[blank for demonstration]

Number of Patients
Tested for HIV (c)
[blank for demonstration]

Section L—Depression Measures

Line

Preventive Care and Screening:
Screening for Depression and
Follow-Up Plan

21

MEASURE: Percentage of patients
12 years of age and older who were
(1) screened for depression with a
standardized tool and, if screening
was positive, (2) had a follow-up plan
documented

Line

Depression Remission at Twelve
Months

21a

MEASURE: Percentage of patients
12 years of age and older with major
depression or dysthymia who reached
remission 12 months (+/- 60 days)
after an index event

21

Total Patients Aged 12
and Older (a)

Number of
Records Reviewed
(b)

[blank for
demonstration]

[blank for
demonstration]

Total Patients Aged 12
and Older with Major
Depression or
Dysthymia (a)
[blank for
demonstration]

Number of
Records Reviewed
(b)
[blank for
demonstration]

2025 UDS REPORTING TABLES | Instructions for Table 6B

Number of Patients
Screened for
Depression and
Follow-Up Plan
Documented as
Appropriate (c)
[blank for
demonstration]

Number of Patients
who Reached
Remission (c)
[blank for
demonstration]

UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM
Section M—Dental Sealants for Children between 6–9 Years

Line

Dental Sealants for Children
between 6–9 Years

22

MEASURE: Percentage of children 6
through 9 years of age at moderate to
high risk of caries who received a
sealant on a first permanent molar

Total Patients Aged 6
through 9 at Moderate
to High Risk for
Caries (a)

[blank for demonstration]

Number of
Records Reviewed
(b)

Number of Patients
with Sealants to First
Molars (c)

[blank for demonstration]

[blank for demonstration]

Section N—Substance Use Disorder (SUD) Measures

Line

23a

23b

22

Initiation and Engagement of
Substance Use Disorder (SUD)
Treatment
MEASURE: Percentage of patients
with a new SUD episode who
initiated treatment, including either
an intervention or medication for the
treatment of SUD, within 14 days of
the new SUD episode
MEASURE: Percentage of patients
with a new SUD episode who
engaged in ongoing treatment,
including two additional interventions
or medication treatment events for
SUD, or one long-acting medication
event for the treatment of SUD,
within 34 days of the initiation

Total Patients Aged 13
and Older Diagnosed
with a New SUD
Episode (a)

Number of
Records Reviewed
(b)

Number of Patients
who Received SUD
Treatment (c)

[blank for demonstration]

[blank for demonstration]

[blank for demonstration]

[blank for demonstration]

[blank for demonstration]

[blank for demonstration]

2025 UDS REPORTING TABLES | Instructions for Table 6B

UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM

TABLE 7: HEALTH OUTCOMES

Calendar Year: January 1, 2025, through December 31, 2025

Line
0
2
Line
1a1m 1a2m 1a3m 1a4m 1a5m 1a6m 1a7m 1b1m 1b2m 1b3m 1b4m 1cm 1dm 1em 1fm 1gm subtotal 1a1p 1a2p 1a3p 1a4p 1a5p 1a6p 1a7p 1b1p 1b2p 1b3p 23 Description HIV-Positive Pregnant Women Deliveries Performed by Health Center’s Providers Section A: Deliveries and Birth Weight Race and Ethnicity Mexican, Mexican American, Chicano/a Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Mexican, Mexican American, Chicano/a Puerto Rican Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Prenatal Care Patients Who Delivered During the Year (1a) Patients (a) Live Births: <1500 grams (1b) Live Births: 1500–2499 grams (1c) Live Births: ≥2500 grams (1d)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line Race and Ethnicity 1b4p 1cp 1dp 1ep 1fp 1gp Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Puerto Rican Cuban Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Cuban Another Hispanic, Latino/a, or Spanish Origin Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander subtotal 1a1c 1a2c 1a3c 1a4c 1a5c 1a6c 1a7c 1b1c 1b2c 1b3c 1b4c 1cc 1dc 1ec 1fc 1gc subtotal 1a1a 1a2a 1a3a 1a4a 1a5a 1a6a 1a7a 1b1a 1b2a 24 Prenatal Care Patients Who Delivered During the Year (1a) Live Births: <1500 grams (1b) Live Births: 1500–2499 grams (1c) Live Births: ≥2500 grams (1d)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line Race and Ethnicity 1b3a 1b4a 1ca 1da 1ea 1fa 1ga Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Another Hispanic, Latino/a, or Spanish Origin Hispanic, Latino/a, or Spanish Origin Combined Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Hispanic, Latino/a, or Spanish Origin, Combined Total Hispanic, Latino/a, or Spanish Origin Not Hispanic, Latino/a, or Spanish Origin Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian subtotal 1a1o 1a2o 1a3o 1a4o 1a5o 1a6o 1a7o 1b1o 1b2o 1b3o 1b4o 1co 1do 1eo 1fo 1go subtotal 2a1 2a2 2a3 2a4 2a5 2a6 2a7 25 Prenatal Care Patients Who Delivered During the Year (1a) Live Births: <1500 grams (1b) Live Births: 1500–2499 grams (1c) Live Births: ≥2500 grams (1d)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line Race and Ethnicity 2b1 2b2 2b3 2b4 2c 2d 2e 2f 2g Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Total Not Hispanic, Latino/a, or Spanish Origin Unreported/Chose Not to Disclose Race and Ethnicity Unreported/Chose Not to Disclose Race and Ethnicity Total subtotal h i 26 Prenatal Care Patients Who Delivered During the Year (1a) Live Births: <1500 grams (1b) Live Births: 1500–2499 grams (1c) Live Births: ≥2500 grams (1d)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Section B: Controlling High Blood Pressure Line 1a1m 1a2m 1a3m 1a4m 1a5m 1a6m 1a7m 1b1m 1b2m 1b3m 1b4m 1cm 1dm 1em 1fm 1gm subtotal 1a1p 1a2p 1a3p 1a4p 1a5p 1a6p 1a7p 1b1p 1b2p 1b3p 1b4p 1cp 1dp 27 Race and Ethnicity Mexican, Mexican American, Chicano/a Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Mexican, Mexican American, Chicano/a Puerto Rican Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native Total Patients 18 through 85 Years of Age with Hypertension (2a) Number of Records Reviewed (2b) Patients with Hypertension Controlled (2c)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line Race and Ethnicity 1ep 1fp 1gp White More than One Race Unreported/Chose Not to Disclose Race Subtotal Puerto Rican Cuban Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Cuban Another Hispanic, Latino/a, or Spanish Origin Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American subtotal 1a1c 1a2c 1a3c 1a4c 1a5c 1a6c 1a7c 1b1c 1b2c 1b3c 1b4c 1cc 1dc 1ec 1fc 1gc subtotal 1a1a 1a2a 1a3a 1a4a 1a5a 1a6a 1a7a 1b1a 1b2a 1b3a 1b4a 1ca 28 Total Patients 18 through 85 Years of Age with Hypertension (2a) Number of Records Reviewed (2b) Patients with Hypertension Controlled (2c)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line Race and Ethnicity 1da 1ea 1fa 1ga American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Another Hispanic, Latino/a, or Spanish Origin Hispanic, Latino/a, or Spanish Origin, Combined Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Hispanic, Latino/a, or Spanish Origin, Combined Total Hispanic, Latino/a, or Spanish Origin Not Hispanic, Latino/a, or Spanish Origin Asian Indian Chinese Filipino Japanese Korean Vietnamese subtotal 1a1o 1a2o 1a3o 1a4o 1a5o 1a6o 1a7o 1b1o 1b2o 1b3o 1b4o 1co 1do 1eo 1fo 1go subtotal 2a1 2a2 2a3 2a4 2a5 2a6 29 Total Patients 18 through 85 Years of Age with Hypertension (2a) Number of Records Reviewed (2b) Patients with Hypertension Controlled (2c)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line Race and Ethnicity 2a7 2b1 2b2 2b3 2b4 2c 2d 2e 2f 2g Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Total Not Hispanic, Latino/a, or Spanish Origin Unreported/Chose Not to Disclose Race and Ethnicity Unreported/Chose Not to Disclose Race and Ethnicity Total subtotal h i 30 Total Patients 18 through 85 Years of Age with Hypertension (2a) Number of Records Reviewed (2b) Patients with Hypertension Controlled (2c)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Section C: Diabetes: Glycemic Status Assessment Greater Than 9% Line 1a1m 1a2m 1a3m 1a4m 1a5m 1a6m 1a7m 1b1m 1b2m 1b3m 1b4m 1cm 1dm 1em 1fm 1gm Subtotal 1a1p 1a2p 1a3p 1a4p 1a5p 1a6p 1a7p 1b1p 1b2p 1b3p 1b4p 1cp 31 Race and Ethnicity Mexican, Mexican American, Chicano/a Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Mexican, Mexican American, Chicano/a Puerto Rican Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American Total Patients 18 through 75 Years of Age with Diabetes (3a) Number of Records Reviewed (3b) Patients with Glycemic Status Assessment >9%, Missing, or No Test During Year (3f)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line Race and Ethnicity 1dp 1ep 1fp 1gp American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Puerto Rican Cuban Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Cuban Another Hispanic, Latino/a, or Spanish Origin Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Subtotal 1a1c 1a2c 1a3c 1a4c 1a5c 1a6c 1a7c 1b1c 1b2c 1b3c 1b4c 1cc 1dc 1ec 1fc 1gc Subtotal 1a1a 1a2a 1a3a 1a4a 1a5a 1a6a 1a7a 1b1a 1b2a 1b3a 32 Total Patients 18 through 75 Years of Age with Diabetes (3a) Number of Records Reviewed (3b) Patients with Glycemic Status Assessment >9%, Missing, or No Test During Year (3f)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line Race and Ethnicity 1b4a 1ca 1da 1ea 1fa 1ga Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Another Hispanic, Latino/a, or Spanish Origin Hispanic, Latino/a, or Spanish Origin, Combined Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Subtotal Hispanic, Latino/a, or Spanish Origin Total Hispanic, Latino/a, or Spanish Origin Not Hispanic, Latino/a, or Spanish Origin Asian Indian Chinese Filipino Subtotal 1a1o 1a2o 1a3o 1a4o 1a5o 1a6o 1a7o 1b1o 1b2o 1b3o 1b4o 1co 1do 1eo 1fo 1go Subtotal 2a1 2a2 2a3 33 Total Patients 18 through 75 Years of Age with Diabetes (3a) Number of Records Reviewed (3b) Patients with Glycemic Status Assessment >9%, Missing, or No Test During Year (3f)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line Race and Ethnicity 2a4 2a5 2a6 2a7 2b1 2b2 2b3 2b4 2c 2d 2e 2f 2g Japanese Korean Vietnamese Other Asian Native Hawaiian Other Pacific Islander Guamanian or Chamorro Samoan Black or African American American Indian/Alaska Native White More than One Race Unreported/Chose Not to Disclose Race Total Not Hispanic, Latino/a, or Spanish Origin Unreported/Chose Not to Disclose Race and Ethnicity Unreported/Chose Not to Disclose Race and Ethnicity Total subtotal h i 34 Total Patients 18 through 75 Years of Age with Diabetes (3a) Number of Records Reviewed (3b) Patients with Glycemic Status Assessment >9%, Missing, or No Test During Year (3f)
2025 UDS REPORTING TABLES | Instructions for Table 7 UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM TABLE 8A: FINANCIAL COSTS Calendar Year: January 1, 2025, through December 31, 2025 Line Cost Center [section divide] Financial Costs of Medical Care 1 2 3 4 [blank for section divide] 5 6 7 8a 8b 9 9a 10 [blank for section divide] 11a 11b 11c 11d 11e 11f 11g 11h 11 12 12a 13 35 Medical Personnel Lab and X-ray Medical/Other Direct Total Medical Care Services (Sum of Lines 1 through 3) Financial Costs of Other Clinical Services Dental Mental Health Substance Use Disorder Pharmacy (not including pharmaceuticals) Pharmaceuticals Other Professional (specify___) Vision Total Other Clinical Services (Sum of Lines 5 through 9a) Financial Costs of Enabling and Other Services Case Management Transportation Outreach Health Education Eligibility Assistance Interpretation Services Other Enabling Services (specify___) Community Health Workers Total Enabling Services (Sum of Lines 11a through 11h) Other Program-Related Services (specify___) Quality Improvement Total Enabling and Other Services (Sum of Lines 11, 12, and 12a) Accrued Cost (a) Allocation of Facility and NonClinical Support Services (b) Total Cost After Allocation of Facility and NonClinical Support Services (c) [section divide] [section divide] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for section divide] [blank for section divide] [blank for section divide] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [Cell not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for section divide] [blank for section divide] [blank for section divide] [blank for demonstration] [Cell not reported] [blank for demonstration] [blank for demonstration] [Cell not reported] [blank for demonstration] [blank for demonstration] [Cell not reported] [blank for demonstration] [blank for demonstration] [Cell not reported] [blank for demonstration] [blank for demonstration] [Cell not reported] [blank for demonstration] [blank for demonstration] [Cell not reported] [blank for demonstration] [blank for demonstration] [Cell not reported] [blank for demonstration] [blank for demonstration] [Cell not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] 2025 UDS REPORTING TABLES | Instructions for Table 8A [section divide] UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Line [blank for section divide] 14 15 16 17 18 19 36 Cost Center Facility and Non-Clinical Support Services and Totals Facility Non-Clinical Support Services Total Facility and Non-Clinical Support Services (Sum of Lines 14 and 15) Total Accrued Costs (Sum of Lines 4 + 10 + 13 + 16) Value of Donated Facilities, Services, and Supplies (specify___) Total with Donations (Sum of Lines 17 and 18) Accrued Cost (a) Allocation of Facility and NonClinical Support Services (b) Total Cost After Allocation of Facility and NonClinical Support Services (c) [blank for section divide] [blank for section divide] [blank for section divide] [blank for demonstration] [Cell not reported] [Cell not reported] [blank for demonstration] [Cell not reported] [Cell not reported] [blank for demonstration] [Cell not reported] [Cell not reported] [blank for demonstration] [Cell not reported] [blank for demonstration] [Cell not reported] [Cell not reported] [blank for demonstration] [Cell not reported] [Cell not reported] [blank for demonstration] 2025 UDS REPORTING TABLES | Instructions for Table 8A UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM TABLE 9D: PATIENT SERVICE REVENUE Calendar Year: January 1, 2025, through December 31, 2025 [blank for demonstration] [blank for demonstration] [blank for demonstration] Full Charges This Period (a) Line Payer Category 1 Medicaid Non-Managed Care 2a 2b 3 Medicaid Managed Care (capitated) Medicaid Managed Care (feefor-service) Total Medicaid (Sum of Lines 1 + 2a + 2b) [blank for demonstration] Amount Collected This Period (b) [blank for demonstration] Retroactive Settlements, Receipts, and Paybacks (c) Collection Collection of Collection of of Other Reconciliation/ Reconciliation/ Penalty/ Payments: Payback Wraparound Wraparound P4P, Risk (c4) Current Year Previous Years Pools, etc. (c1) (c2) (c3) Adjustments (d) [blank for demonstration] Sliding Fee Discounts (e) [blank for demonstration] Bad Debt Write -Off (f) [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] 4 Medicare Non-Managed Care Medicare Managed Care (capitated) [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] 5a Medicare Managed Care (feefor-service) [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] 5b Total Medicare (Sum of Lines 4 + 5a + 5b) Other Public, including NonMedicaid CHIP, Non-Managed Care Other Public, including NonMedicaid CHIP, Managed Care (capitated) Other Public, including NonMedicaid CHIP, Managed Care (fee-for-service) Total Other Public (specify [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] 6 7 8a 8b 9 37 _______) (Sum of Lines 7 + 8a + 8b) 2025 UDS REPORTING TABLES | Instructions for Table 9D UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM [blank for demonstration] [blank for demonstration] [blank for demonstration] Full Charges This Period (a) Line Payer Category 10 Private Non-Managed Care 11a 11b 12 Private Managed Care (capitated) Private Managed Care (fee-forservice) Total Private (Sum of Lines 10 + 11a + 11b) 13 Self-Pay 14 TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) 38 [blank for demonstration] Amount Collected This Period (b) Retroactive Settlements, Receipts , and Paybacks (c) Collection of Collection of Collection of Other Reconciliation/ Reconciliation/ Penalty/ Payments: Wraparound Wraparound Payback P4P, Risk Current Year Previous Years (c4) Pools, etc. (c1) (c2) (c3) [blank for demonstration] Adjustments (d) [blank for demonstration] Sliding Fee Discounts (e) [blank for demonstration] Bad Debt Write -Off (f) [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [not reported] [not reported] [not reported] [not reported] [not reported] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] 2025 UDS REPORTING TABLES | Instructions for Table 9D UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM TABLE 9E: OTHER REVENUES Calendar Year: January 1, 2025, through December 31, 2025 Line Source [blank] HRSA’s BPHC Grants (Enter Amount Drawn Down—Consistent with FFR) Migratory and Seasonal Agricultural Workers Community Health Center Homeless Population Residents of Public Housing Total Health Center (Sum of Lines 1a through 1e) Capital Development Grants American Rescue Plan (ARP) (H8F, L2C, C8E) Other COVID-19-Related Funding from HRSA’s BPHC (specify _______) Total COVID-19 Supplemental (Sum of Lines 1o + 1p2) Total HRSA’s BPHC Grants (Sum of Lines 1g + 1k + 1q) Other Federal Grants Ryan White Part C HIV Early Intervention Other Federal Grants (specify _______) Promoting Interoperability Program Total Other Federal Grants (Sum of Lines 2 through 3a) Non-Federal Grants or Contracts State Government Grants and Contracts (specify_______) State/Local Indigent Care Programs (specify_______) Local Government Grants and Contracts (specify_______) Foundation/Private Grants and Contracts (specify_______) Total Non-Federal Grants and Contracts (Sum of Lines 6 + 6a + 7 + 8) Other Revenue (non–patient service revenue not reported elsewhere) (specify _____) Total Revenue (Sum of Lines 1 + 5 + 9 + 10) 1a 1b 1c 1e 1g 1k 1o 1p2 1q 1 [blank] 2 3 3a 5 [blank] 6 6a 7 8 9 10 11 39 2025 UDS REPORTING TABLES | Instructions for Table 9E [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] [blank] Amount (a) UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Appendix D: Health Center Health Information Technology (Health IT) Capabilities INTRODUCTION The Health IT Capabilities Form collects information through a series of questions on the health center’s health IT capabilities, including EHR interoperability and eligibility for CMS Promoting Interoperability Program. The Health IT Capabilities Form must be completed and submitted as part of the UDS submission. The form includes questions about the health center’s implementation of an EHR, certification of systems, and how widely adopted the system is throughout the health center and its providers. The text directly below indicates changes from 2024 calendar year reporting to 2025 calendar year reporting: There are no key changes to this form. This marks the conclusion of changes from 2024 calendar year reporting to 2025 calendar year reporting. QUESTIONS The following questions appear in the EHBs. Complete them before you file the UDS Report. Reporting requirements for the health IT questions are on-screen in the EHBs as you complete the form. Respond to each question based on your health center status as of December 31, 2025. 1. Does your health center currently have an electronic health record (EHR) system installed and in use, at a minimum, for medical care, by December 31? a. Yes, installed at all service delivery sites and used by all providers b. Yes, but only installed at some service delivery sites or used by some providers c. No 40 • For the purposes of this response, “providers” mean all fully trained medical providers, including physicians, nurse practitioners, physician assistants, and certified nurse midwives. • Although some or all of the dental, mental health, or other providers may also be using the system, as may medical support personnel, this is not required to choose response (a). • For the purposes of this response, “all service delivery sites” means all permanent service delivery sites where medical providers serve health center medical patients on a regular basis. • It DOES NOT include administrative-only locations, hospitals or nursing homes, mobile vans, or sites used on a seasonal or temporary basis. • You may check this option if a few newly hired, untrained personnel are the only ones not using the system. • Select option (b) if one or more permanent service delivery sites did NOT have the EHR installed or in use (even if this is planned), or if one or more fully trained medical providers (as defined on above in [a]) do not yet use the system. • When determining if all providers have access to the system, the health center should also consider part-time and locum providers who serve clinic patients. • DO NOT select this option if the only medical providers who did not have access were those who were newly hired and still being trained on the system. • Select “no” if no EHR was in use on December 31, even if you had the system installed and training had started. • If the health center purchased an EHR but has not yet put it into use, answer “no.” 2025 UDS REPORTING TABLES | Appendix D UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM If response is “c. No,” skip to Question 11. If response is “a” or “b,” continue to next question. If more than one medical EHR is used, answer “Yes,” to Question 1 and select “a” if they are used at all service delivery sites and used by all providers or select “b” if they are used at some service delivery sites or used by some providers. If “Yes, but only installed at some service delivery sites or used by some providers” is selected, a box expands for health centers to identify how many service delivery sites have the EHR in use and how many (medical) providers are using it. Please enter the number of service delivery sites (as defined under question 1) where the EHR is in use and the number of providers who use the system (at all service delivery sites). Include part-time and locum medical providers who serve clinic patients. Count a provider who has separate login identities at more than one service delivery site as just one provider. This next set of questions seeks to determine whether the health center installed an EHR by December 31 and, if so, which product was in use, how broad system access was, and what features were available and in use. DO NOT include PMS or other billing systems, even though they can often produce much of the UDS data. If a system is in use (i.e., if [a] or [b] has been selected), indicate whether it has been certified by the Assistant Secretary for Technology Policy (ASTP)/Office of the National Coordinator (ONC)—Authorized Testing and Certification Bodies. Note: ASTP/ONC has mandated new regulations under the Base EHR Definition as part of the Health Data, Technology, and Interoperability (HTI-1) final rule, which specifically adds the Decision Support Interventions (DSI) certification criterion (45 CFR 170.315(b)(11)) and mandates all certified EHR technologies (CEHRT) comply by January 1, 2025. 1a. Is your system certified by the Assistant Secretary for Technology Policy (ASTP)/Office of the National Coordinator for Health Information Technology (ONC) Health IT Certification Program? a. Yes b. No Health centers are to indicate the vendor, product name, version number, and ASTP-/ONC-certified health IT product list number. This information is available on the Certified Health IT Product List (CHPL). Select the most current version number being used. If you have more than one EHR (if, for example, you acquired another practice with its own EHR), report the EHR that will be the successor system or the EHR used for capturing primary medical care. 1a1. Vendor 1a2. Product Name 1a3. Version Number 1a4. ASTP-/ONC-certified Health IT Product List Number Note: The CHPL Number is a standardized number that reflects your certified product and version. Stepby-step instructions for using the CHPL to find your system are available in the CHPL Public User Guide. 1b. Did you switch to your current EHR from a previous system during the calendar year? a. Yes b. No 41 2025 UDS REPORTING TABLES | Appendix D UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM 1c. Do you use more than one EHR, data collection, and/or data analytics system across your organization? Select “Yes” if the health center has more than one EHR that flows into one central health IT/EHR or practice management system. a. Yes b. No 1c1. If yes, what is the reason? a. Additional EHR/data system(s) are used during transition from one primary EHR to another b. Additional EHR/data system(s) are specific to one or more service types (e.g., dental, behavioral health, care coordination) c. Additional EHR/data system(s) are used at specific service delivery sites with no plan to transition d. Additional EHR/data system(s) are used for analysis and reporting (such as for clinical quality measures or custom reporting) e. Other (please describe ______) 1d. Question removed. 1e. Question removed. 2. Question removed. 3. Question removed. 4. Which of the following key providers/health care settings does your health center electronically exchange clinical or patient information with? (Select all that apply.) a. Hospitals/Emergency rooms b. Specialty providers c. Other primary care providers d. Labs or imaging e. Health information exchange (HIE) 2 f. Community-based organizations/social service partners g. None of the above (Please select “None of the above” only if none of the other options apply.) h. Other (please describe ______) 5. Does your health center engage patients through health IT in any of the following ways? (Select all that apply.) a. Patient portals b. Kiosks c. Secure messaging between patient and provider d. Online or virtual scheduling e. Automated electronic outreach for care gap closure or preventive care reminders 2 HIEs are typically state or regional data exchanges that support information sharing between different organizations, provider types, and technology vendors. More information on HIEs can be found on the Health Information Exchange webpage. 42 2025 UDS REPORTING TABLES | Appendix D UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM f. Application programming interface (API) patient access to their health record through mHealth apps 3 g. Other (please describe _______) h. No, we DO NOT engage patients using health IT (Please select “No, we DO NOT engage patients using health IT” only if none of the other options apply.) 6. Question removed. 7. Question removed. 8. Question removed. 9. Question removed. 10. How does your health center utilize health IT and EHR data beyond direct patient care? (Select all that apply.) a. Quality improvement (e.g., outreach, health education) b. Population health management c. Program evaluation and planning (e.g., grants, needs assessments, strategic planning) d. Research d1. Financial monitoring (e.g., value-based incentives, reimbursements) e. Other (please describe ______) f. We DO NOT utilize health IT or EHR data beyond direct patient care (Please select “We DO NOT utilize health IT or EHR data beyond direct patient care” only if none of the other options apply.) 11. Does your health center collect data on individual patients’ health-related needs, outside of the data countable in the UDS? Note: Health centers should respond “a. Yes” below only if they are screening for health-related needs, meaning they have a consistent set of questions that are asked of individual patients uniformly for the purposes of collecting information on the non-medical, health-related needs of patients, such as housing instability and/or food insecurity, beyond those demographic patient characteristics captured elsewhere on the UDS Report. Collecting race, ethnicity, and/or income level would not be considered here as collecting data on individual patients’ health-related needs, as this information is already counted in the UDS Report, on Tables 3B and 4. Similarly, collecting data on intimate partner violence, domestic violence, and/or human trafficking would not be considered, as this information is already counted in the UDS Report, on Table 6A. a. Yes b. No, but we are in planning stages to collect this information c. No, we are not planning to collect this information If response to Question 11 is “a,” then continue to the next question. If response is “b” or “c,” skip to Question 12b. 3 More information on How APIs in Health Care can Support Access to Health Information: Learning Module 43 2025 UDS REPORTING TABLES | Appendix D UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM 11a. How many health center patients were screened for health-related needs using a standardized screener during the calendar year? (Only respond to this if the response to Question 11 is “a. Yes” and count only patients who completed (some of or all of) the screener) _____________ 12. Which standardized screener(s) for health-related needs, if any, did you use during the calendar year? (Select all that apply. Only respond to this if your response to Question 11a is greater than 0.) a. Accountable Health Communities Screening Tools b. Upstream Risks Screening Tool and Guide c. IHELLP d. Recommend Social and Behavioral Domains for EHRs e. Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) f. Well Child Care, Evaluation, Community Resources, Advocacy, Referral, Education (WE CARE) g. WellRx h. Health Leads Screening Toolkit i. Other (please describe: __________) Note: Health centers that are screening for health-related needs, using the definition noted in Question 11, but are NOT using one of the standardized screening tools listed should respond “i. Other.” Specify that you are using standardized questions from various screening tools. j. We DO NOT use a standardized screener (response to Question 12b is required when selected) Note: Only select “j. We DO NOT use a standardized screener” if you DO NOT use a consistent set of questions/approach to screen patients for health-related needs. If Question 11a is greater than 0 and the health center responds to Question 12, continue to the next question. If Question 11a is 0 and Question 12 is any option other than “j,” skip to Question 13. 12a. Of the total patients screened for health-related needs (Question 11a), please provide the total number of patients that screened positive for any of the following at any point during the calendar year. (A patient may experience multiple health-related needs and should be counted once for each risk factor they screened positive for, regardless of the number of times screened during the year.) a. Food insecurity ___________ b. Housing insecurity ___________ c. Financial strain ___________ d. Lack of transportation/access to public transportation ___________ 12b. If you DO NOT use a standardized screener to collect this information, please indicate why. (Select all that apply.) (Only respond to this question if your response to Question 11a is “zero” or if Question 12, option j is selected.) a. Have not considered/unfamiliar with standardized screeners b. Lack of funding for addressing these unmet health-related needs of patients c. Lack of training for personnel to discuss these issues with patients d. Inability to include with patient intake and clinical workflow e. Not needed f. 44 Other (please describe ___________) 2025 UDS REPORTING TABLES | Appendix D UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM 13. Does your health center integrate a statewide Prescription Drug Monitoring Program (PDMP) database into the health information systems, such as health information exchanges, EHRs, and/or pharmacy dispensing software (PDS) to streamline provider access to controlled substance prescriptions? a. Yes b. No c. Not sure 45 2025 UDS REPORTING TABLES | Appendix D UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Appendix E: Other Data Elements INTRODUCTION The questions on the Other Data Elements Form collect information on the changing landscape of health centers to include expanded services and delivery systems. The text directly below indicates changes from 2024 calendar year reporting to 2025 calendar year reporting: There are no key changes to this form. This marks the conclusion of changes from 2024 calendar year reporting to 2025 calendar year reporting. QUESTIONS Topics on this form include medications for opioid use disorder (MOUD), telehealth, outreach and enrollment assistance, and screenings for family planning needs. Respond to each question based on your health center status as of December 31, 2025. 1. Medications for Opioid Use Disorder (MOUD) a. How many providers, on-site or with whom the health center has contracts, are eligible to treat opioid use disorder with medications specifically approved by the U.S. Food and Drug Administration (FDA) (i.e., buprenorphine, methadone, naltrexone) for that indication during the calendar year? b. During the calendar year, how many patients received MOUD from a provider accounted for in Question 1a? Note: Review the applicable value set from Table 6A, Line 26c3, for MOUD. The number of patients included on Table 6A should be the same as patients reported in this form, Question 1b. 2. Did your organization use telemedicine to provide remote (virtual) clinical care services? Note: Telemedicine services refers to remote clinical services for patients. a. Yes If “Yes” is selected, proceed to questions 2a1–2a3. 2a1. Who did you use telemedicine to communicate with? (Select all that apply.) a. Patients at remote locations from your organization (e.g., home telehealth, satellite locations) b. Specialists outside your organization (e.g., specialists at referral centers) 2a2. What telehealth technologies did you use? (Select all that apply.) a. Real-time telehealth (e.g., live videoconferencing) b. Store-and-forward telehealth (e.g., secure email with photos or videos of patient examinations) c. Remote patient monitoring (e.g., electronic transmission of data from patients to health care providers, such as vital signs, pulse, blood pressure) d. Mobile Health (mHealth) (e.g., patient technologies, like smartphones and tablet apps) 46 2025 UDS REPORTING TABLES | Appendix E UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM 2a3. What primary telemedicine services were used at your organization? (Select all that apply.) a. Primary care b. Oral health c. Behavioral health: Mental health d. Behavioral health: Substance use disorder e. Dermatology f. Chronic conditions g. Disaster management h. Consumer health education i. Provider-to-provider consultation j. Radiology k. Nutrition and dietary counseling Other (Please describe ________________) l. b. No. If you did not use telemedicine services, please comment on why. (Select all that apply.) a. Have not considered/unfamiliar with telehealth service options b. Policy barriers (Select all that apply.) i. Lack of or limited reimbursement ii. Credentialing, licensing, or privileging iii. Privacy and security iv. Other (Please describe __________________) c. Inadequate broadband/telecommunication service (Select all that apply.) i. Cost of service ii. Lack of infrastructure iii. Other (Please describe __________________) d. Lack of funding for telehealth equipment e. Lack of training for telehealth services f. Not needed g. Other (Please describe __________________) 47 2025 UDS REPORTING TABLES | Appendix E UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM 3. Provide the number of all assists provided during the past year by all trained assisters (e.g., certified application counselor or equivalent) working on behalf of the health center (personnel, contracted personnel, or volunteers), regardless of the funding source that is supporting the assisters’ activities. Outreach and enrollment assists are defined as customizable education sessions about third-party primary care health insurance coverage options (one-on-one or small group) and any other assistance provided by a health center assister to facilitate enrollment. Enter number of assists _______________ Note: Assists DO NOT count as visits on the UDS tables. 4. How many health center patients were screened for voluntary family planning, including contraceptive methods, using a standardized screener during the calendar year? ______________ 48 2025 UDS REPORTING TABLES | Appendix E UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM Appendix F: Workforce INTRODUCTION The Workforce Form collects information through a series of questions on health center workforce. It is important to understand the current state of health center workforce training and staffing models to better support recruitment and retention of health center professionals. The text directly below indicates changes from 2024 calendar year reporting to 2025 calendar year reporting: There are no key changes to this form. This marks the conclusion of changes from 2024 calendar year reporting to 2025 calendar year reporting. QUESTIONS Report on these data elements as part of your UDS submission. Topics include health professional education/training (DO NOT include continuing education units) and satisfaction surveys. Respond to each question based on your health center status as of December 31, 2025. 1. Does your health center provide any health professional education/training that is a hands-on, practical, or clinical experience? a. Yes b. No 1a. If yes, which categories describe your health center’s role in the health professional education/training process? (Select all that apply.) a. Sponsor 4 b. Training site partner 5 c. Other (please describe ________________) 2. If yes, please indicate the range of health professional education/training offered at your health center and how many individuals you have trained in each category 6 within the calendar year. (Do not answer this question if your response to question 1 was No). Note: Line 1, below, is the count of individuals, regardless of their specialty. Lines 1a–1f are to account for the multiple specialties that an individual has received or may be receiving training for during the calendar year (e.g., an Internist + other specialty). Note: Line 25, Other, may include students interested in health care (e.g., internships, master’s-level placements); students enrolled in specialized training, such as radiology; social work; phlebotomy; physical therapy, and occupational therapy; pharmacy technicians; and community health workers, for example. 4 A sponsor hosts a comprehensive health profession education and/or training program, the implementation of which may require partnerships with other entities that deliver focused, time-limited education and/or training (e.g., a teaching health center with a family medicine residency program). 5 A training site partner delivers focused, time-limited education and/or training to learners in support of a comprehensive curriculum hosted by another health profession education provider (e.g., month-long primary care dentistry experience for dental students). 6 Examples of pre-graduate/certificate training include student clinical rotations or externships. A residency, fellowship, or practicum would be examples of post-graduate training. Include non-health-center individuals trained by your health center. 49 2025 UDS REPORTING TABLES | Appendix F UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM [blank] a. Pre-Graduate/Certificate b. Post-Graduate Training Medical [blank] [blank] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] 1. Physicians a. Family Physicians b. General Practitioners c. Internists d. Obstetrician/Gynecologists e. Pediatricians f. Other Specialty Physicians 2. Nurse Practitioners 3. Physician Assistants 4. Certified Nurse Midwives 5. Registered Nurses 6. Licensed Practical Nurses/ Vocational Nurses 7. Medical Assistants [blank] Dental 8. Dentists 9. Dental Hygienists 10. Dental Therapists 10a. Dental Assistants Mental Health and Substance Use Disorder 11. Psychiatrists 12. Clinical Psychologists 13. Clinical Social Workers 14. Professional Counselors 15. Marriage and Family Therapists 16. Psychiatric Nurse Specialists 17. Mental Health Nurse Practitioners 18. Mental Health Physician Assistants 19. Substance Use Disorder Personnel [blank] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank] Vision 20. Ophthalmologists 21. Optometrists Other Professionals 22. Chiropractors 23. Dieticians/Nutritionists 24. Pharmacists 25. Other (please describe ________) 50 [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] 2025 UDS REPORTING TABLES | Appendix F [blank] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank] [blank for demonstration] [blank for demonstration] [blank] [blank for demonstration] [blank for demonstration] [blank for demonstration] [blank for demonstration] UDS SUPPORT CENTER, 866-UDS-HELP, UDSHELP330@BPHCDATA.NET, BPHC CONTACT FORM 3. Provide the number of health center personnel serving as preceptors 7 at your health center: ____ 4. Provide the number of health center personnel (non-preceptors) supporting ongoing health center training programs: ____ 5. How often does your health center conduct satisfaction surveys to providers (as identified in Appendix A, Listing of Personnel) working for the health center? Report only provider surveys here. (Select one.) a. Monthly b. Quarterly c. Annually d. We DO NOT currently conduct provider satisfaction surveys e. Other (please describe _________) 6. How often does your health center conduct satisfaction surveys for general personnel (as identified in Appendix A, Listing of Personnel) working for the health center (report provider surveys in question 5 only)? (Select one.) a. Monthly b. Quarterly c. Annually d. We DO NOT currently conduct personnel satisfaction surveys e. Other (please describe _________) 7 A preceptor is a teacher or experienced professional who helps students and staff learners apply theory to practice. 51 2025 UDS REPORTING TABLES | Appendix F 2025 UDS Tables—June 18, 2025 OMB Number: 0915-0193 Expiration Date: 04/30/2026
File Typeapplication/pdf
File TitleUniform Data System 2025 REPORTING TABLES Health Center Data Reporting Requirements
SubjectHRSA, BPHC, UDS, Health Center Program, health center
AuthorHRSA
File Modified2025-06-24
File Created2025-06-21

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