Medicare AdvantageCoverageMedium impact
MA08.151d, Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer's Disease
Independence Blue Cross·Neurology, Geriatrics, Internal Medicine·Medical Policy
Effective date
Nov 13, 2024
We identified it
Jun 19, 2026
Summary
This is a recent reissuance of the MA08.151d policy effective November 13, 2024, governing coverage and billing for monoclonal antibodies directed against amyloid for Alzheimer's disease treatment under Medicare Advantage plans. The billing team must verify current coverage criteria, prior authorization requirements, and applicable billing codes for these specialty medications to ensure compliant claim submission.
Action Required
By March 15, 2025: Billing team must obtain and review the complete MA08.151d policy text from the provided source URL to identify: (1) specific HCPCS codes for amyloid-directed monoclonal antibodies covered under this policy, (2) prior authorization requirements and procedures, (3) medical necessity documentation requirements, and (4) any limitations or exclusions. Update billing software and clinical encounter templates accordingly. Communicate findings to providers treating Alzheimer's disease patients and infusion/pharmacy staff. Do not bill for amyloid-directed monoclonal antibodies under Medicare Advantage without first confirming coverage status and obtaining required prior authorization, as claims will be denied for non-compliance with MA08.151d requirements.