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00.01.25br, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services

Independence Blue Cross·Diagnostic Imaging, PM&R (Physical Medicine & Rehab), Physical Therapy·Network
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

PPO network rules have been updated for specialty services including durable medical equipment (DME), laboratory, radiology, and physical medicine/rehabilitation services effective January 1, 2025. This policy change affects how these specialty services are accessed within the PPO network structure.

Action Required

Action needed
Immediately: Review current referral patterns for DME, laboratory, radiology, and physical medicine services to ensure compliance with updated PPO network requirements. Verify that all referred providers are within the updated network guidelines. Update staff training on new network rules for these specialty service categories.