CommercialBilling CodesLow impact
11.09.02s, Gender-Affirming Interventions
Independence Blue Cross·NY · Endocrinology, Psychiatry·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated policy 11.09.02s to 11.09.02t, replacing HCPCS code S0189 with J1073 for testosterone pellet implants (75 mg), effective 01/01/2026. New York members now require medical necessity review per attached guidance. This is a standard code update with no changes to coverage criteria.
Action Required
By January 1, 2026: Billing team must update billing software to replace HCPCS code S0189 with J1073 for testosterone pellet implants (75 mg) on all claims. Remove S0189 from active billing codes to prevent submission errors. For New York members, ensure claims are flagged for medical necessity review per the 'Services Subject to Medical Necessity Review for New York Members' attachment. No changes needed to coverage criteria or prior authorization requirements.