Medicare AdvantageCoverageMedium impact
MA07.003f, Photodynamic Therapy Using Verteporfin (Visudyne®)
Independence Blue Cross·Ophthalmology·Pharmacy
Effective date
Feb 2, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA07.003f for Photodynamic Therapy Using Verteporfin (Visudyne®) has been updated with changes to coverage criteria, medical necessity requirements, and billing codes. This pharmacy policy affects reimbursement positions and general guidelines for this specialized eye treatment.
Action Required
By February 2, 2026: Review updated policy MA07.003f for Photodynamic Therapy Using Verteporfin (Visudyne®) at the provided URL. Update billing procedures for medical necessity documentation requirements and verify any coding changes for verteporfin treatments. Ensure prior authorization processes align with new coverage criteria to prevent claim denials.