CommercialCoverageMedium impact
02.01.02e, Private Duty Nursing
Independence Blue Cross·Medical Policy
Effective date
Dec 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated their medical necessity criteria for Private Duty Nursing services under policy 02.01.02e. This policy change affects the requirements that must be met for private duty nursing services to be considered medically necessary and covered.
Action Required
By December 1, 2025: Billing and clinical teams must review the updated medical necessity criteria for private duty nursing services. Update prior authorization procedures and documentation requirements according to the new policy guidelines. Ensure all private duty nursing claims meet the revised medical necessity standards to avoid denials.