Medicare AdvantageCoverageMedium impact
MA00.001f, Not Medically Necessary Services and Obsolete or Unreliable Diagnostic Tests
Independence Blue Cross·Medical Policy
Effective date
Jan 12, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage has updated their medical policy MA00.001f regarding services that are not medically necessary and diagnostic tests that are obsolete or unreliable. This policy change affects medical necessity criteria and medical coding requirements for Medicare Advantage plans.
Action Required
By January 12, 2026: Billing team must review and update medical necessity documentation requirements for Medicare Advantage claims. Verify that all diagnostic tests being billed are not on the obsolete/unreliable list. Update prior authorization workflows to align with new medical necessity criteria. Review coding practices to ensure compliance with updated policy requirements.