Provider Alerts

Measurement Year 2024 Healthcare Effectiveness Data Information Set (HEDIS)

BCS-E – Breast Cancer screening

Patients assigned female at birth ages 50-74 who have not undergone chest reconstruction or breast reduction should have at least one mammogram every 2 years.

CCS – Cervical Cancer Screening

Patients assigned female at birth with an intact cervix should be screened:

• 21 – 64 years of age – Every 3 years – Cervical Cytology screening only.
  • Note: Patients must be AT LEAST 21 years old at time of service.
• 30 – 64 years of age – Every 5 years – Cervical high-risk human papillomavirus (hrHPV) testing only OR Cervical cytology screening with high-risk human papillomavirus (hrHPV) co-testing.
  • Note: Patients must be AT LEAST 30 years old at the time of service.

Recommended Best Practice:

• Educate members about the importance of early detection and screening.
• Establish standing orders for annual mammograms.
• Document dates and results for all patient provided information on past screenings and testing.
• Review and document patients’ surgical history with dates and results.
• Document historical dates of mastectomy bilateral or unilateral status.
• Document historical dates of hysterectomy with specificity of type such as total, complete, no residual cervix etc.

If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-7526 (PLAN). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org