Medicare AdvantageCoverageHigh impact
MA09.002ag, High-Technology Radiology Services
Independence Blue Cross·Radiology, Diagnostic Imaging·Medical Policy
Effective date
Apr 4, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage updated their high-technology radiology services policy with changes to medical necessity criteria and general guidelines. This affects coverage requirements for advanced imaging procedures like MRI, CT, and PET scans.
Action Required
Before April 4, 2026: Billing team must review updated medical necessity criteria for high-technology radiology services. Update prior authorization workflows and ensure documentation requirements meet new guidelines. Train staff on revised coverage criteria to prevent claim denials for advanced imaging procedures.