CommercialAdministrativeMedium impact
00.01.25bs, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Independence Blue Cross·PM&R (Physical Medicine & Rehab), Radiology·Network
Effective date
Apr 1, 2025
We identified it
Jun 19, 2026
Summary
PPO network rules have been updated for specialty services including durable medical equipment (DME), laboratory, radiology, and physical medicine/rehabilitation services. This affects how providers within the PPO network can deliver and bill for these specialty services.
Action Required
Before April 1, 2025: Billing team must review updated PPO network rules for DME, lab, radiology, and PM&R services at the source URL. Verify current network status for specialty service providers and update referral processes to ensure compliance with new network requirements. Non-compliance may result in out-of-network penalties or claim denials.