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Medicare AdvantageReimbursementHigh impact

MA00.049c, Reimbursement for Certain Evaluation and Management (E/M) Services

Independence Blue Cross·Claims & Billing
Effective date
Mar 2, 2026
We identified it
Jun 19, 2026
Days to comply

Summary

Medicare Advantage has updated its reimbursement policy for certain Evaluation and Management (E/M) services. This policy change affects both coverage and reimbursement positions for E/M visits and will take effect March 2, 2026.

Action Required

Action needed
Before March 2, 2026: Billing team must review the complete policy MA00.049c at the source URL to understand specific E/M reimbursement changes. Update billing system configurations and fee schedules for Medicare Advantage E/M services based on the new coverage and reimbursement positions. Train staff on any new documentation or coding requirements for E/M visits.