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MA00.004b, Routine Costs of Clinical Trials and Coverage of Investigational Devices A and B
Effective date
Not stated in the notice
Identified
Jun 19, 2026
Summary
This is a reissue with no substantive changes to MA00.004b, a Medicare Advantage policy governing coverage and billing for routine costs associated with qualifying clinical trials. The policy clarifies that routine costs must be submitted to the local Medicare Administrative Contractor (MAC), not to Independence Blue Cross, and that Original Medicare pays first, with the MA plan paying secondary benefits after MAC adjudication.
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What to do
Action · 5 steps
01No immediate action required.
02This reissue (effective 11/26/2025) contains no changes to benefit criteria or billing requirements.
03However, billing team should ensure current processes reflect that all routine clinical trial costs are submitted to the local MAC, not retained for company processing.
04Verify that claims submission workflows direct clinical trial claims appropriately to MAC, not to Independence Blue Cross directly.
05No system updates, code changes, or documentation modifications are needed at this time.
Codes mentioned
Z00.6
Original notice
MA00.004b, Routine Costs of Clinical Trials and Coverage of Investigational Devices A and B
medpolicy.ibx.com · Always check the source before changing claims.
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