Medicare AdvantageCoverageMedium impact
MA05.038, Cardiac Contractility Modulation
Independence Blue Cross·Cardiology, Cardiothoracic Surgery·Medical Policy
Effective date
Oct 28, 2025
We identified it
Jun 19, 2026
Summary
MA05.038 is a new Medicare Advantage policy establishing coverage criteria and billing guidelines for Cardiac Contractility Modulation (CCM) therapy. This is a new policy effective 10/28/2025 that the billing team must implement immediately to ensure proper claim processing and avoid denials.
Action Required
By 10/28/2025: Billing team must obtain and review the complete MA05.038 policy text from the source URL to identify specific CPT/HCPCS codes, prior authorization requirements, medical necessity documentation requirements, and coverage limitations for cardiac contractility modulation procedures. Update billing software, prior authorization workflows, and provider education materials accordingly. Contact the policy source (IBX Medicare Advantage) to request detailed billing guidance if specific codes are not clearly outlined in the policy. Failure to implement proper prior authorization and documentation requirements will result in claim denials for CCM procedures.