Medicare AdvantageCoverageMedium impact
MA05.044v, Durable Medical Equipment (DME)
Independence Blue Cross·MA · Orthopedics, Physical Therapy, Occupational Therapy +3 more·Medical Policy
Effective date
Nov 10, 2025
We identified it
Jun 19, 2026
Summary
Policy MA05.044v has been updated with changes to Durable Medical Equipment (DME) coverage and/or reimbursement for Medicare Advantage plans, effective November 10, 2025. The policy includes updates to medical coding guidelines and general coverage descriptions. Billing teams must review and implement any new coverage criteria, coding requirements, or reimbursement adjustments to avoid claim denials.
Action Required
By November 10, 2025: Billing team must access the full policy text at the provided URL to identify specific DME codes, coverage criteria, and reimbursement changes. Update billing system rules, prior authorization templates, and claim submission processes to reflect new guidelines. Communicate changes to providers and obtain staff training on new coding or documentation requirements. Verify all DME claims submitted after the effective date comply with updated policy. Contact the payer directly if specific affected codes are not clearly listed in the policy summary.