Medicare AdvantageCoverageMedium impact
Preventive Coverage Update of Combined Chlamydia and Gonorrhea Testing for Medicare Advantage Members (Retroactively effective 01/01/2026)
Independence Blue Cross·Infectious Disease, Family Medicine, Internal Medicine +1 more·News & Announcements
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage plans are updating preventive coverage to include combined Chlamydia and Gonorrhea testing, effective retroactively as of January 1, 2026. This change means these screening tests should now be covered as preventive services for eligible MA members with no cost-sharing requirements.
Action Required
By April 15, 2026: Billing team must update billing software and encounter forms to reflect combined Chlamydia and Gonorrhea testing as a covered preventive service for all Medicare Advantage members. Remove any prior authorization requirements if previously required. Providers should document that testing is being billed as preventive care with zero patient cost-sharing. Reprocess any claims from January 1, 2026 forward that were denied or billed with cost-sharing, as they should have been covered retroactively. Verify with your Medicare Advantage plans which specific CPT/HCPCS codes they use for this combined testing to ensure accurate billing.