CommercialDocumentationHigh impact
00.06.02av, Preventive Care Services
Independence Blue Cross·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Policy 00.06.02av has been updated to modify medical necessity criteria for preventive care services effective July 1, 2025. The billing team must review and implement new medical necessity requirements for preventive care claims to ensure compliance and avoid denials.
Action Required
By July 1, 2025: Billing team and clinical staff must review the full policy text at https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=07&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-00-06-02av to identify specific medical necessity criteria changes. Update billing system rules, encounter forms, and provider documentation templates to reflect new medical necessity requirements for preventive care services. Providers must ensure all preventive care claims include required medical necessity documentation. Claims submitted without updated documentation will be subject to denial. Notify all clinical staff of criteria changes immediately.