Medicare AdvantageAdministrativeMedium impact
MA00.037m, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
Independence Blue Cross·Claims & Billing
Effective date
Nov 26, 2025
We identified it
Jun 19, 2026
Summary
Policy MA00.037m provides billing guidance for professional office-based services delivered in outpatient settings located within a facility or on a facility campus under Medicare Advantage plans. This reissue (effective 11/26/2025) clarifies billing requirements and site-of-service rules for services performed in office-based settings that are physically located within or adjacent to a facility.
Action Required
By 11/26/2025: Billing team must review MA00.037m policy in full to understand site-of-service billing requirements for office-based services located within facility campuses. Confirm that all current billing practices for facility-based office services comply with the reissued guidance. Update any internal documentation or billing protocols that may conflict with the new policy. Contact the Medicare Advantage plan or refer to the full policy text at the provided URL for specific code-level billing rules and any prior authorization requirements.