All Insurance Policy Changes (Page 1141)

Continuing from page 1140. Showing older policy changes tracked across all payers. Use the filters in the related-hubs section below to narrow by provider, state, or specialty.

Medium impact
MA07.035g, Therapeutic Transcranial Magnetic Stimulation (TMS)
Independence Blue Cross·Effective Jan 1, 2026
Medicare Advantage has updated their policy MA07.035g for Therapeutic Transcranial Magnetic Stimulation (TMS) effective January 1, 2026. This is a very recent policy change that may affect coverage criteria, billing requirements, or documentation standards for TMS treatments under Medicare Advantage plans.
Medium impact
MA05.054l, Urological Supplies
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage policy MA05.054l for Urological Supplies has been updated with an effective date of April 1, 2026. This is a summary-only notification, so specific details about coverage changes, billing requirements, or prior authorization modifications are not provided in the source material.
Medium impact
MA05.057f, Upper-Limb Prostheses
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage policy MA05.057f for Upper-Limb Prostheses has been updated with new provisions effective April 1, 2026. This policy change affects coverage criteria, billing requirements, or documentation standards for upper extremity prosthetic devices and related services.
Medium impact
MA05.024k, Lower Limb Prostheses
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage policy MA05.024k for Lower Limb Prostheses has been updated with new coverage or billing requirements. This policy specifically affects prosthetic services and billing for Medicare Advantage members only.
Medium impact
MA08.052p, Denosumab (Prolia®, Xgeva®) and related biosimilars, and Romosozumab-aqqg (Evenity®)
Independence Blue Cross·Effective Apr 1, 2026
This policy governs coverage and reimbursement for Denosumab (Prolia®, Xgeva®), related biosimilars, and Romosozumab-aqqg (Evenity®) for Medicare Advantage members. The policy is effective April 1, 2026, and billing teams must ensure claims for these medications are processed according to the specific coverage criteria outlined in MA08.052p to avoid denials.
Medium impact
MA08.189a, Pembrolizumab and berahyaluronidase alfa-pmph (KEYTRUDA QLEX™)
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage has updated their policy for Pembrolizumab and berahyaluronidase alfa-pmph (KEYTRUDA QLEX™), a cancer immunotherapy drug. This policy change will take effect April 1, 2026 and may affect coverage criteria, prior authorization requirements, or billing procedures for this oncology medication.
Medium impact
MA08.045p, Tocilizumab and Related Biosimilars for Intravenous Infusion and Subcutaneous Injection
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage updated their policy for tocilizumab and related biosimilars for both intravenous infusion and subcutaneous injection administration. This policy change affects coverage, billing, or authorization requirements for this rheumatoid arthritis and other inflammatory condition medication.
Medium impact
MA08.009y, Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage policy MA08.009y for Immune Globulin Intravenous (IVIG) and Subcutaneous (SCIG) has been updated with an effective date of April 1, 2026. This policy change affects billing and coverage requirements for immunoglobulin therapies under Medicare Advantage plans.
Medium impact
MA00.036m, Telehealth Services
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage telehealth services policy MA00.036m has been updated with an effective date of April 1, 2026. This is a very recent policy change that may affect telehealth billing procedures and coverage requirements for Medicare Advantage patients.
Medium impact
MA11.015ag, Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage policy MA11.015ag for wound care skin substitutes used in treating burns and chronic, non-healing wounds has been updated. This policy affects coverage and billing for skin substitute products and related wound care procedures.
Medium impact
MA06.006h, Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapy
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage policy MA06.006h for Lyme Disease diagnosis and IV antibiotic therapy has been updated. This affects coverage and potentially prior authorization requirements for Lyme disease treatment including intravenous antibiotics.
Medium impact
MA05.045g, Compression Garments
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage policy MA05.045g for compression garments has been updated with an effective date of April 1, 2026. This is a very recent policy change that requires immediate attention from the billing team to understand new coverage criteria and billing requirements for compression garments.
Medium impact
MA08.188b, Linvoseltamab-gcpt (Lynozyfic)
Independence Blue Cross·Effective Apr 1, 2026
A new Medicare Advantage policy for Linvoseltamab-gcpt (Lynozyfic), a specialty pharmaceutical agent, has been posted and will take effect on April 1, 2026. This appears to be a new drug coverage policy that will likely impact billing and prior authorization requirements for this medication.
Medium impact
MA05.047p, Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults
Independence Blue Cross·Effective Jan 1, 2026
Medicare Advantage policy MA05.047p for Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults has been updated with an effective date of January 1, 2026. This is a fresh policy change that may affect coverage criteria, billing requirements, or documentation standards for sleep apnea treatments.
Medium impact
MA12.011f, Prescription Digital Therapeutics and Mobile-Based Health Management Applications
Independence Blue Cross·Effective Apr 1, 2026
Medicare Advantage has updated its policy MA12.011f regarding coverage and billing for prescription digital therapeutics and mobile-based health management applications. This policy change affects how providers can bill for digital health tools and apps prescribed to Medicare Advantage patients.
Medium impact
MA11.076h, Removal of Breast Implants
Independence Blue Cross·Effective Apr 29, 2026
Medicare Advantage policy MA11.076h for Removal of Breast Implants has been reissued and updated. This is a fresh policy change that affects coverage and billing procedures for breast implant removal services under Medicare Advantage plans.
Medium impact
MA08.085k, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)
Independence Blue Cross·Effective Apr 29, 2026
This is a reissue of the existing policy MA08.085k covering Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®), a specialty pharmaceutical agent used in oncology. The policy was reissued effective 04/29/2026 with a posted date of 04/29/2026. Without access to the full policy text content, specific coverage changes cannot be determined, but billing teams should review the reissued policy for any updates to coverage criteria, prior authorization requirements, or billing guidance.
Medium impact
MA08.181a, Zolbetuximab-clzb (Vyloy®)
Independence Blue Cross·Effective Apr 29, 2026
Medicare Advantage policy MA08.181a for Zolbetuximab-clzb (Vyloy®), a specialty pharmacy medication, has been reissued with an effective date of April 29, 2026. This is a future-dated policy update that will impact coverage and billing for this oncology medication.
Low impact
MA08.140c, Anifrolumab-fnia (Saphnelo®)
Independence Blue Cross·Effective Apr 29, 2026
Medicare Advantage policy MA08.140c for Anifrolumab-fnia (Saphnelo®) has been reissued with an effective date of April 29, 2026. This appears to be a pharmacy policy update, though specific coverage or billing changes are not detailed in the summary provided.
Medium impact
MA06.017aa, Molecular Diagnostics
Independence Blue Cross·Effective Apr 29, 2026
Medicare Advantage policy MA06.017aa for Molecular Diagnostics has been reissued with an effective date of April 29, 2026. This is a policy update that may contain changes to coverage criteria, billing requirements, or prior authorization rules for molecular diagnostic testing under Medicare Advantage plans.
Medium impact
MA11.093a, Surgical Treatments of Athletic Pubalgia
Independence Blue Cross·Effective Apr 29, 2026
Medicare Advantage policy MA11.093a for Surgical Treatments of Athletic Pubalgia has been reissued with an effective date of April 29, 2026. This policy update affects surgical procedures for athletic pubalgia (sports hernias) and may contain changes to coverage criteria or prior authorization requirements.
Medium impact
MA07.009j, Routine Foot Care for Certain Medical Conditions
Independence Blue Cross·Effective Apr 29, 2026
Medicare Advantage policy MA07.009j for routine foot care for certain medical conditions has been reissued with an effective date of April 29, 2026. This is a policy reissuance that may contain updates to coverage criteria or billing requirements for routine foot care services when provided for specific medical conditions.
Medium impact
MA05.060f, External Infusion Pumps
Independence Blue Cross·Effective Apr 29, 2026
Medicare Advantage policy MA05.060f for External Infusion Pumps has been reissued and will become effective April 29, 2026. This is a fresh policy update that may contain changes to coverage, prior authorization, or billing requirements for external infusion pump services.
Medium impact
MA08.050c, Alpha-1 Antitrypsin Therapy (e.g., Prolastin-C, Aralast NP, Glassia, Zemaira)
Independence Blue Cross·Effective Apr 29, 2026
The Alpha-1 Antitrypsin Therapy policy (MA08.050c) covering medications like Prolastin-C, Aralast NP, Glassia, and Zemaira has been reissued for Medicare Advantage plans. This is a policy update affecting coverage and billing for these specialty respiratory medications used to treat Alpha-1 antitrypsin deficiency.
Medium impact
MA10.001c, Pulmonary Rehabilitation
Independence Blue Cross·Effective Apr 29, 2026
Medicare Advantage policy MA10.001c for Pulmonary Rehabilitation has been reissued and will take effect on April 29, 2026. This is a policy update that may contain changes to coverage criteria, billing requirements, or documentation standards for pulmonary rehabilitation services.

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Archive by year

2023 2024 2025 2026

MA07.035g, Therapeutic Transcranial Magnetic Stimulation (TMS)

MA05.054l, Urological Supplies

MA05.057f, Upper-Limb Prostheses

MA05.024k, Lower Limb Prostheses

MA08.052p, Denosumab (Prolia®, Xgeva®) and related biosimilars, and Romosozumab-aqqg (Evenity®)

MA08.189a, Pembrolizumab and berahyaluronidase alfa-pmph (KEYTRUDA QLEX™)

MA08.045p, Tocilizumab and Related Biosimilars for Intravenous Infusion and Subcutaneous Injection

MA08.009y, Immune Globulin Intravenous (IVIG), Subcutaneous (SCIG)

MA00.036m, Telehealth Services

MA11.015ag, Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds

MA06.006h, Lyme Disease: Diagnosis and Intravenous (IV) Antibiotic Therapy

MA05.045g, Compression Garments

MA08.188b, Linvoseltamab-gcpt (Lynozyfic)

MA05.047p, Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults

MA12.011f, Prescription Digital Therapeutics and Mobile-Based Health Management Applications

MA11.076h, Removal of Breast Implants

MA08.085k, Asparaginase Erwinia Chrysanthemi (recombinant)-rywn (Rylaze®)

MA08.181a, Zolbetuximab-clzb (Vyloy®)

MA08.140c, Anifrolumab-fnia (Saphnelo®)

MA06.017aa, Molecular Diagnostics

MA11.093a, Surgical Treatments of Athletic Pubalgia

MA07.009j, Routine Foot Care for Certain Medical Conditions

MA05.060f, External Infusion Pumps

MA08.050c, Alpha-1 Antitrypsin Therapy (e.g., Prolastin-C, Aralast NP, Glassia, Zemaira)

MA10.001c, Pulmonary Rehabilitation