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MA05.057f, Upper-Limb Prostheses

Independence Blue Cross·Orthopedics, PM&R (Physical Medicine & Rehab), Plastic Surgery·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Days to comply

Summary

Medicare Advantage policy MA05.057f for Upper-Limb Prostheses has been updated with new provisions effective April 1, 2026. This policy change affects coverage criteria, billing requirements, or documentation standards for upper extremity prosthetic devices and related services.

Action Required

Action needed
Before April 1, 2026: Billing team must review updated MA05.057f policy for Upper-Limb Prostheses coverage criteria. Access full policy details at the provided URL to identify specific changes to prior authorization requirements, documentation standards, or billing procedures for prosthetic services. Update billing workflows and staff training accordingly.