Medicare AdvantageCoverageMedium impact
MA11.051b, Treatment of Obesity and Bariatric Surgery for Treatment of Morbid Obesity
Independence Blue Cross·General Surgery, Endocrinology, Family Medicine +1 more·Medical Policy
Effective date
Feb 24, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage policy MA11.051b for Treatment of Obesity and Bariatric Surgery has been updated with changes to coverage criteria, medical necessity requirements, and coding guidelines. This affects billing for obesity treatment and bariatric surgery procedures under Medicare Advantage plans.
Action Required
By February 24, 2025: Billing team must review updated MA11.051b policy for obesity and bariatric surgery coverage changes. Update billing system and encounter forms to reflect new medical necessity criteria and coding requirements for Medicare Advantage plans. Providers should verify coverage criteria before scheduling bariatric procedures to prevent claim denials.