Medicare AdvantageDocumentationMedium impact
MA00.003ag, Preventive Care Services
Independence Blue Cross·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage has updated medical necessity criteria and coding requirements for preventive care services. This change affects how billing teams must document and code preventive services for Medicare Advantage members.
Action Required
Before April 1, 2026: Billing team must review and update medical necessity documentation requirements for all preventive care services billed to Medicare Advantage plans. Update billing software coding rules and train staff on new medical necessity criteria. Ensure encounter forms reflect updated requirements to prevent claim denials.