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MA05.025g, Pressure-Reducing Support Surfaces
Effective date
Oct 28, 2026
Identified
Nov 3, 2026
Summary
Independence Blue Cross Medicare Advantage added a face-to-face encounter requirement for HCPCS code E0194 (Air fluidized bed) effective 10/28/2026. The practice must obtain documentation of a face-to-face visit before ordering this device, and should obtain prior authorization before delivery.
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What to do
Action · 3 steps
01Effective 10/28/2026: Before scheduling or ordering HCPCS code E0194 (Air fluidized bed) for Independence Blue Cross Medicare Advantage members, ensure the ordering provider has completed a face-to-face encounter with the patient and obtain prior authorization from the payer before delivery.
02Billing team should update charge entry and prior authorization workflows to require documentation that the face-to-face visit occurred and that prior authorization was obtained before claims are submitted.
03Notify providers and front desk staff that E0194 now requires a documented face-to-face encounter and prior auth; claims without prior authorization will be denied.
Codes mentioned
E0194
Original notice
MA05.025g, Pressure-Reducing Support Surfaces
medpolicy.ibx.com · Always check the source before changing claims.