Medicare AdvantageCoverageMedium impact
MA12.011f, Prescription Digital Therapeutics and Mobile-Based Health Management Applications
Independence Blue Cross·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage has updated its policy MA12.011f regarding coverage and billing for prescription digital therapeutics and mobile-based health management applications. This policy change affects how providers can bill for digital health tools and apps prescribed to Medicare Advantage patients.
Action Required
Before April 1, 2026: Billing team must review updated policy MA12.011f to understand new coverage criteria for prescription digital therapeutics and mobile health apps for Medicare Advantage patients. Update billing workflows and staff training materials to ensure compliance with new requirements. Contact Medicare Advantage plans directly for specific billing codes and prior authorization requirements as they may vary by plan.