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Breast cancer screening: A vital routine for life-saving outcomes
Cigna·Family Medicine, Internal Medicine, OB-GYN +2 more·General
Effective date
Jan 1, 2025
We identified it
Jun 18, 2026
Summary
Cigna Healthcare updated breast cancer screening guidelines to align with 2024 USPSTF recommendations, now covering mammograms for women aged 40-74 (expanded from 50-74). HEDIS measures for 2025 have been updated to reflect this expanded age range with new age stratifications.
Action Required
By January 1, 2025: Billing team must update systems to ensure mammography screening codes (77061-77067) are processed as preventive care with no patient cost-sharing for women aged 40-74 at in-network locations. Update encounter forms and staff training to reflect the expanded age range from the previous 50-74 to now include women 40-49. Verify billing software recognizes the new HEDIS age stratifications (40-49, 50-74, total rate) for quality reporting.