What Are the MEAT Criteria?

MEAT is an acronym that stands for Monitoring, Evaluating, Assessing, and Treating. These four criteria define the minimum documentation standard that must be met before a chronic condition can be captured as an HCC for risk adjustment purposes.

A condition listed only in the past medical history or problem list — without any MEAT documentation in the current encounter — cannot be coded for HCC capture.

Breaking Down Each Element

Monitoring

The provider is actively monitoring the condition through:

Ordering or reviewing lab results related to the condition

Tracking vital signs or symptoms over time

Scheduling follow-up visits specifically for the condition

Reviewing imaging or diagnostic test results

Example: A provider reviews an HbA1c result of 7.2% for a patient with Type 2 Diabetes Mellitus. This demonstrates monitoring of the diabetic condition.

Evaluating

The provider is evaluating the current status or progression of the condition:

Noting whether the condition is stable, improving, or worsening

Comparing current findings to previous encounters

Assessing for complications or related conditions

Documenting symptom changes

Example: "Patient's COPD is stable on current medication regimen. No exacerbations since last visit." This shows evaluation of the COPD status.

Assessing

The provider documents their clinical assessment or impression:

Including the condition in the assessment and plan section

Providing a clinical impression of the condition's severity

Documenting the condition's impact on overall health

Noting any differential diagnoses considered

Example: "Assessment: Major depressive disorder, moderate, currently well-controlled on sertraline 100mg." This provides a clinical assessment of the condition.

Treating

The provider is actively treating the condition through:

Prescribing, continuing, or adjusting medications

Ordering therapies or treatments

Making referrals to specialists

Providing patient education about managing the condition

Recommending lifestyle modifications

Example: "Continue metformin 1000mg twice daily. Increase lisinopril to 20mg for better blood pressure control." This shows active treatment.

Common MEAT Documentation Mistakes

Problem list only — Listing a condition without any narrative documentation in the visit note

Copy-forward without update — Carrying forward previous notes without adding current encounter details

Missing the A&P — Documenting history and exam findings but not addressing the condition in the Assessment and Plan

Medication list only — Having a medication on the med list without any provider narrative about the condition it treats

How MEAT Applies to HCC Coding

For risk adjustment, every HCC-mapped condition must be:

1. Documented with at least one MEAT element during a face-to-face encounter

2. Coded with the appropriate ICD-10-CM code

3. Supported by the clinical documentation in the visit note

4. From an encounter with a qualified provider type

If a coder cannot find MEAT documentation for a condition, it should not be coded for that encounter — even if the condition is clearly present in the patient's history.

Tips for Coders

Read the full note — MEAT elements can appear anywhere in the documentation, not just the Assessment and Plan

Look for implicit MEAT — A medication refill for a chronic condition is treatment, even if the provider does not explicitly discuss the condition

Query when needed — If documentation is ambiguous, a coder query to the provider can clarify whether a condition was addressed

Use AI assistance — HCC Buddy's AI coding assistant can help identify MEAT elements in documentation scenarios

Try the AI assistant at hccbuddy.com/encoder — ask it any MEAT criteria question.

MEAT Criteria for HCC Coding: Documentation Requirements