Medicare AdvantageCoverageMedium impact
MA11.004o, Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)
Independence Blue Cross·Urology·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA11.004o has been updated regarding minimally invasive treatments for urinary outlet obstruction due to benign prostatic hyperplasia (BPH). This policy change affects coverage criteria and billing requirements for BPH procedures under Medicare Advantage plans.
Action Required
By July 1, 2025: Review updated policy MA11.004o for minimally invasive BPH treatments. Billing team should verify current coverage criteria and prior authorization requirements for BPH procedures under Medicare Advantage plans. Update billing protocols and ensure providers are aware of any new documentation requirements for urological procedures.