Breast Cancer Screening — HEDIS® Tip Sheet

Oct. 2, 2019

Regular breast cancer screening helps detect breast cancer early when it is most treatable. The National Committee for Quality Assurance (NCQA) requires assessment and documentation of breast cancer screening with a mammogram for women ages 50 to 74. The screening is part of NCQA's Healthcare Effectiveness Data and Information Set (HEDIS) measurements. Help Blue Cross and Blue Shield of Texas (BCBSTX) collect HEDIS data and provide better care for our members by measuring and documenting breast cancer screening.

HEDIS measures are specific but not always intuitive, so we've created a HEDIS Breast Cancer Screen Tip Sheet that captures these requirements and many of the associated codes. This HEDIS Breast Screening Tip Sheet is located on the Clinical Resources page of our provider website in the right–hand bar under Related Resources.

Valid methods of mammography are screening, diagnostic, film, digital or digital breast tomosynthesis.

We appreciate your assistance in helping to improve care by gathering the required HEDIS data measurements for our members.


HEDIS® is a registered trademark of NCQA