For years, health plans have struggled with one of the hardest quality measures in behavioral health: FUI - Follow-Up After High-Intensity Care for Substance Use Disorder.

The measure is straightforward on paper. When a member is discharged from inpatient, residential, or detox for a substance use disorder, did they receive a follow-up visit within 7 days? Within 30 days?

In practice, it's anything but simple. We're talking about people leaving some of the most vulnerable moments of their lives; often returning to unstable environments, fractured support systems, and the same triggers that led them to high-intensity care in the first place. Transportation barriers, stigma, and a national shortage of behavioral health providers make timely follow-up feel almost impossible for many members.

The result? FUI is consistently one of the lowest-performing HEDIS measures across plan types. And it directly impacts Star Ratings, accreditation, and increasingly, reimbursement.

What just changed

Starting in Measurement Year 2026, NCQA made a significant update to the FUI measure: peer support services now count as a qualifying follow-up visit.

This isn't a minor technical tweak. It's a recognition that the traditional model, expecting a member fresh out of detox to navigate scheduling, transportation, and the clinical system within 7 days, has a fundamental gap. NCQA added peer support to the FUI numerator (alongside FUA, FUM, and FUH) for two reasons they stated explicitly:

1. Peer support services, when incorporated into a care team, improve outcomes - especially in substance use populations.

2. The behavioral health workforce shortage requires expanding who can deliver meaningful follow-up.

   
   

A peer recovery coach visit billed under H0038 or T1012 with a SUD diagnosis now satisfies the measure. That changes the math for every health plan in the country.

Why this matters more than most people realize

This isn't just about one HEDIS measure. It signals a broader shift in how NCQA, and by extension, the entire quality measurement ecosystem, views peer support. For the first time, the people closest to the lived experience of recovery are being formally recognized as part of the clinical care continuum for quality reporting purposes.

For health plans, this creates an immediate opportunity. Instead of relying solely on a constrained clinical workforce to close FUI gaps, you can now partner with organizations that deliver certified peer recovery coaching at scale, and have those encounters count.

How we built Accountable for exactly this moment

I co-founded Accountable after my own near-fatal overdose. When I left treatment, there was nothing. No one checking in. No structure. No accountability. I was lucky - I survived the gap. Too many people don't.

That experience is why we built a platform that pairs every member with a certified peer recovery coach who has lived experience in recovery. Our coaches provide weekly video sessions and daily touchpoints, not once the member feels ready, but starting immediately after discharge, when the risk of disengagement is highest.

We also layer in daily breathalyzer monitoring and remote drug and alcohol testing. This does two things: it gives the member real-time accountability (which people in early recovery actually want), and it gives health plans and clinical teams objective data to identify who's struggling before they fall through the cracks.

Everything is virtual. No transportation barriers. No geographic constraints. Members engage from home, which is exactly where they need support most.

What this means for your plan

If you're a health plan leader looking at your FUI performance and wondering how to move the needle, the MY 2026 change creates a clear path:

Partner with a peer support organization that can deliver documented, billable encounters within the 7- and 30-day windows, and that can do it at the scale and consistency your member population requires.

At Accountable, we're already doing this. Our peer coaching sessions are structured for HEDIS compliance, our platform captures the documentation health plans need, and our model was built from day one around the post-discharge window that FUI measures.

We'd welcome the conversation. If you're thinking about how to operationalize the MY 2026 FUI changes, reach out, this is what we do.

Matt Serel is the CEO and Co-Founder of You Are Accountable, a peer recovery coaching and monitoring platform for substance use disorder. Learn more at youareaccountable.com.