Medicare AdvantageCoverageHigh impact
MA11.087c, Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions
Independence Blue Cross·Orthopedics, Pain Management, Sports Medicine·Medical Policy
Effective date
Jul 9, 2025
We identified it
Jun 19, 2026
Summary
Policy MA11.087c for Extracorporeal Shock Wave Therapy (ESWT) was reissued effective 07/09/2025 and posted on 09/09/2025. The policy was simultaneously removed on 09/09/2025, indicating this is a superseded or withdrawn policy. Billing teams must cease using this policy guidance immediately and await clarification on replacement coverage rules for ESWT procedures.
Action Required
Immediately: Billing team must stop referencing policy MA11.087c as it was removed on 09/09/2025. Contact compliance and payer relations to obtain the current replacement policy for ESWT coverage and billing requirements. Do not submit claims based on the reissued MA11.087c guidance. Pending receipt of updated policy guidance, flag all ESWT procedure requests for manual review before claim submission to prevent denials. Providers must be notified of the policy withdrawal to avoid documentation and coding errors.