Who is affected by this change?

This affects Independence Blue Cross OB-GYN, General Surgery, Oncology providers on Medicare Advantage plans.

When does this change take effect?

This change is effective Oct 1, 2025.

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Medicare AdvantageCoverageMedium impact

MA11.077i, Prophylactic Mastectomy, Oophorectomy/Salpingo-Oophorectomy, and Hysterectomy

Independence Blue Cross·OB-GYN, General Surgery, Oncology·Medical Policy

Effective date

Oct 1, 2025

We identified it

Jun 19, 2026

Days to comply

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Summary

Medicare Advantage policy MA11.077i regarding prophylactic mastectomy, oophorectomy/salpingo-oophorectomy, and hysterectomy has been updated effective October 1, 2025. This policy change affects coverage criteria and billing requirements for these preventive surgical procedures.

Action Required

Action needed

By October 1, 2025: Billing team must review updated policy MA11.077i for prophylactic mastectomy, oophorectomy/salpingo-oophorectomy, and hysterectomy procedures. Update prior authorization protocols and documentation requirements for Medicare Advantage plans. Verify coverage criteria changes with payers before scheduling these procedures.

Related policy hubs

Independence Blue Cross policies OB-GYN General Surgery Oncology