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MA11.087c, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
Effective date
Not stated in the notice
Identified
Jun 19, 2026
Summary
Independence Blue Cross has reissued Medical Policy MA11.087c confirming that Extracorporeal Shock Wave Therapy (ESWT) for all musculoskeletal conditions remains experimental/investigational and is NOT covered under Medicare Advantage plans. This is a reissue with no substantive changes to coverage status—ESWT claims will continue to be denied for all diagnoses and all protocol types (high-dose, low-dose, or radial).
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What to do
Action · 4 steps
01Billing team must ensure that all ESWT claims submitted under CPT codes 0101T, 0102T, 28890, or 20999 for Medicare Advantage beneficiaries are flagged as non-covered and denied before submission.
02Update billing system rules and claim scrubbing logic to automatically reject these codes for Independence Blue Cross MA plans.
03Educate providers that ESWT for musculoskeletal conditions (plantar fasciitis, lateral epicondylitis, etc.) is not a covered benefit and inform patients of non-coverage status prior to service delivery to prevent balance billing disputes.
04No prior authorization is required because the service is excluded from coverage entirely.
Codes mentioned
2889020999
Original notice
MA11.087c, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
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