Medicare AdvantageCoverageMedium impact
MA11.117, Peroral Endoscopic Myotomy (POEM) Procedures
Independence Blue Cross·Gastroenterology, General Surgery·Medical Policy
Effective date
Jul 9, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA11.117 for Peroral Endoscopic Myotomy (POEM) procedures has been reissued and will become effective July 9, 2025. This policy update affects coverage and billing requirements for POEM procedures used to treat esophageal motility disorders.
Action Required
Before July 9, 2025: Billing team should review the complete MA11.117 policy document at the provided URL to understand specific coverage criteria and billing requirements for POEM procedures. Update prior authorization processes and billing guidelines for Medicare Advantage patients requiring POEM procedures.