Medicare AdvantageCoverageMedium impact
MA00.005an, Experimental/Investigational Services
Independence Blue Cross·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage has updated their experimental/investigational services policy with changes to coverage and reimbursement positions as well as medical coding requirements. This policy affects how claims for experimental or investigational procedures and services will be covered and coded effective January 1, 2025.
Action Required
Immediately: Billing team must review the full MA00.005an policy at the provided URL to understand specific coverage changes for experimental/investigational services. Update billing system edits and staff training materials based on the new coverage and coding requirements. Verify all pending and future claims for experimental services comply with updated guidelines to prevent denials.