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Medicare AdvantageCoverageMedium impact

MA06.019c, Measurement of Serum Antibodies to and Measurement of Serum Levels of Biologics

Independence Blue Cross·Rheumatology, Gastroenterology, Dermatology +3 more·Medical Policy
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Days to comply

Summary

Policy MA06.019c addresses measurement of serum antibodies to and serum levels of biologics for Medicare Advantage plans, effective 10/01/2025. This is a reissue of existing policy. The billing team must review the full policy text to identify any coverage changes, billing code updates, or prior authorization requirements related to biologic drug level monitoring and antibody testing.

Action Required

Action needed
By 10/01/2025: Billing team must obtain and review the complete policy text at https://medpolicy.ibx.com/ibc/ma/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=10&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#medicare-advantage-ma06-019c-measurement-of-serum-antibodies to identify: (1) specific CPT/HCPCS codes affected, (2) coverage limitations or exclusions, (3) prior authorization requirements, and (4) documentation standards. Update billing system rules, encounter forms, and clinical staff workflows accordingly. Communicate changes to providers ordering biologic drug levels and antibody testing. Failure to implement changes may result in claim denials for non-compliant submissions.