What Is the CCS HEDIS Measure? A Complete Guide for Health Plans

For years, closing a cervical cancer screening gap meant getting a member into an exam room. That’s changing. For HEDIS measurement year 2026, NCQA started accepting HPV tests from self-collected vaginal samples toward the Cervical Cancer Screening (CCS-E) measure. For members ages 30 to 64, a kit mailed to their home can now close the gap.

The CCS HEDIS measure tracks the percentage of members ages 21–64 who were screened for cervical cancer: cervical cytology (a Pap test) within the last 3 years, or a high-risk HPV (hrHPV) test or cotest within the last 5 years for members ages 30–64. Starting in MY 2026, hrHPV tests from self-collected samples count.

What Does the CCS HEDIS Measure Require?

HEDIS is the National Committee for Quality Assurance’s (NCQA) framework for measuring health plan performance. The Cervical Cancer Screening measure gives a member credit for any one of three screening options:

• Cervical cytology (Pap test) within the last 3 years, for members ages 21–64
• hrHPV testing within the last 5 years, for members ages 30–64
• Cytology and hrHPV cotesting within the last 5 years, for members ages 30–64

CCS is now reported as CCS-E, using electronic clinical data. CMS has retired the older version for the Marketplace Quality Rating System.

Where CCS Counts in Quality Programs

CCS isn’t part of Medicare Advantage Star Ratings, but it matters to almost every other line of business:

• NCQA Health Plan Ratings: CCS-E is a required measure for commercial and Medicaid plans.
• Marketplace Quality Rating System: CCS-E is a QRS clinical measure, which feeds the star ratings shown to exchange shoppers.
• Medicaid: Cervical cancer screening is in the 2026 Adult Core Set.

For plans that cover more than one line of business, that adds up to a lot of members ages 21–64 who need screening, and a lot of rating exposure tied to one measure.

Cervical Cancer Screening, by the Numbers

• The American Cancer Society estimates 13,490 new cases of invasive cervical cancer and about 4,200 deaths in 2026.
• Persistent infection with high-risk HPV causes about 95% of cervical cancers, according to the World Health Organization. It usually takes 15 to 20 years for those infected cells to turn into cancer. An HPV test finds the infection early in that window, before cancer develops, which is why guidelines now prefer it as the screening method for women 30 and older.
• Only 75.4% of women ages 21–65 were up to date on cervical cancer screening in 2023, down from 80.0% in 2019. Among women covered by Medicaid or other public insurance, the rate was 69.8%.
• A 2026 study in JAMA Network Open found that nearly 15% of women ages 30–64 have never been screened, and that rate is rising about 5% a year.

Most members already have this screening covered, but the gap exists where many don’t know they’re due, and it isn’t easy for them to fit an exam into their week.

How Self-Collection Changed the Measure

Self-collection for HPV testing went from a research topic to standard guidance in about two years:

• 2024: The FDA approved HPV testing of self-collected samples in health care settings.
• 2025: The FDA approved the first device for collecting a cervical cancer screening sample at home. Later that year, the American Cancer Society updated its guideline to say self-collected vaginal samples are acceptable for HPV screening.
• 2026: HRSA updated the Women’s Preventive Services Guidelines to say patient-collected hrHPV testing “should be offered as an option” for women 30–65 at average risk. HRSA found self-collected samples were about as accurate as clinician-collected ones. For most plans, coverage without cost-sharing takes effect in 2027.

NCQA followed soon after. Its MY 2026 Technical Update added self-collected vaginal samples to the hrHPV test codes for CCS-E, citing the ACS guideline.

One limit is worth knowing: self-collection only applies to hrHPV testing, so it closes gaps for members ages 30–64. Members ages 21–29 can only meet the measure with cytology, which still needs a clinician.

At-Home HPV Testing: Reaching the Members Who Haven’t Come In

Research shows what happens when the kit goes to the member. In a randomized trial of nearly 20,000 underscreened women at Kaiser Permanente Washington, 26% of those mailed an HPV self-sampling kit got screened, compared with 17% of those who received more traditional outreach.

That trial used a kit and standard reminders, but Ash pairs the kit with outreach built to get it returned:

• White-labeled kits and outreach, so members see their health plan’s name on everything
• Email, SMS, and IVR outreach that works together, in English and Spanish. Members who get Ash’s multi-channel outreach complete testing 2.4× more often than with single-channel methods¹, which means more closed CCS gaps
• Clinician oversight of every test, from the order through review of lab results
• Follow-up for positive results, with clinicians on record to act on abnormal lab results, plus capture of each member’s PCP information and lab results faxed to their doctor
• Real-time reporting, so quality teams can see who has returned a kit and who still needs outreach

Follow-up matters here more than with most measures: a positive HPV result isn’t a diagnosis, it means the member needs a clinician visit for more testing. Plans should plan for that from the start, so a closed gap leads to the right care.

Members ages 45–64 fall into both the CCS and colorectal cancer screening (COL) age ranges, so many of them could be due for an HPV test and a FIT at the same time. Ash can send both kits in one outreach as part of a broader cancer screening program, so a single outreach can close two gaps for the same member.

Building a CCS Program Around Self-Collection

Start with the members the new rules help most: those ages 30–64 with no cytology in 3 years and no HPV test in 5. For many plans, that group has been the hardest to reach, and mailed kits are built for them. Members ages 21–29 still need a clinic-based Pap test, so keep provider outreach going for that group.

Plan for the full loop too: outreach, kit return, lab results, and clinician follow-up for anyone who tests positive. The ACS also advises repeating a negative self-collected HPV test in 3 years rather than 5, so build that into the re-screening schedule.

If your plan wants to close more cervical cancer screening gaps, Ash can help. Our gap closure programs bring at-home HPV testing to your members under your brand, with the outreach it takes to get kits returned. Talk to our team about building a program for your health plan.

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CCS HEDIS Measure FAQs

Do self-collected HPV tests count for the CCS HEDIS measure?
Yes. Starting in MY 2026, NCQA counts hrHPV tests from self-collected vaginal samples toward CCS-E for members ages 30–64.

Can members ages 21–29 close the CCS gap at home?
No. Members in that age group can only meet the measure with cervical cytology (a Pap test), which a clinician collects.

Is CCS a Medicare Star Ratings measure?
No. CCS-E counts in NCQA Health Plan Ratings for commercial and Medicaid plans, and in the Marketplace Quality Rating System.

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