Medicare AdvantageBilling CodesLow impact
MA11.010d, Abortion
Independence Blue Cross·OB-GYN, General Surgery·Medical Policy
We identified it
Jun 19, 2026
Summary
Independence Blue Cross reissued MA11.010d (Abortion) on 04/01/2026 with no substantive changes to coverage criteria. Two methotrexate HCPCS codes (J8611, J8612) were added to the policy's medication code list. The policy continues to cover abortion only for rape/incest or life-endangering physical conditions, with required medical documentation.
Action Required
By 04/01/2026: Billing team must update billing software to recognize and process HCPCS codes J8611 (Methotrexate jylamvo, oral, 2.5 mg) and J8612 (Methotrexate xatmep, oral, 2.5 mg) when billed under the medical benefit (Part B) for non-surgical abortion. Ensure that claims for these drugs include required documentation certifying medical necessity under one of the two covered indications (rape/incest or life-endangering physical condition). No changes to coverage criteria or prior authorization processes are required. This is an informational reissue with no substantive policy changes.