Sept. 21, 2026
We encourage you to remind our members that routine screening is the best way to detect breast cancer early.
Breast cancer screening for women should begin at 40, and screenings should continue every other year until age 74, according to the U.S. Preventive Services Task Force. See our preventive care guidelines for more details.
Consider the following tips to close care gaps:
- Talk with our members about breast cancer risk factors and the importance of regular screening for women. We have member education that may help.
- Breast cancer disproportionately affects Black women, according to the Centers for Disease Control and Prevention. Talk with our members about the unique risks and barriers they may face, which can result in poorer outcomes compared with other women.
- Document screenings in members’ electronic medical records. Indicate the specific date and result. This helps us track member progress on the Breast Cancer Screening quality measure from the National Committee for Quality Assurance.
- Document medical and surgical history in the medical record, including dates. Document bilateral mastectomies with the correct date in the medical record. Use correct diagnosis and procedure codes. Submit claims and encounter data in a timely manner. Upload any mammogram or exclusion records into Availity® Essentials.
- Follow up with members if they miss their appointments and help them reschedule.
- For members who need language assistance, let them know we offer help and information in their language at no cost. To speak to an interpreter, members may call the customer service number on their member ID cards.
- For Medicaid members who have transportation barriers, let them know we provide free nonemergency transportation services.
- For men at high risk, the American Cancer Society recommends discussing how to manage their risks.
Resources: Refer to our Quality Care 2026 booklet on HEDIS measures for information on documentation and coding for quality measures. You can access it in Availity Essentials within our Payer Spaces in the resources section. Other resources include:
- Adult wellness guidelines
- Preventive care guidelines
- Clinical practice guidelines
- Texas Immunization Registry ImmTrac2
- Quality improvement toolkits and tip sheets for Medicaid providers
- Texas Health Steps for Medicaid providers
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to Blue Cross and Blue Shield of Texas. BCBSTX makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.