Medicare AdvantageCoverageMedium impact
MA06.036, Protein Biomarkers for the Diagnosis and Cancer Risk Assessment of Prostate Cancer
Independence Blue Cross·Urology, Oncology, Family Medicine +1 more·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA06.036 regarding protein biomarkers for prostate cancer diagnosis and risk assessment has been reissued with an effective date of October 1, 2025. This is a policy reissuance that may affect coverage criteria or billing requirements for prostate cancer biomarker testing.
Action Required
Before October 1, 2025: Review the complete MA06.036 policy document for specific coverage criteria and billing requirements for prostate cancer protein biomarker testing. Update prior authorization workflows and documentation requirements as specified in the full policy. Ensure billing team understands any changes to medical necessity criteria for Medicare Advantage patients requiring prostate cancer biomarker testing.