Medicare AdvantageCoverageMedium impact
MA12.011d, Prescription Digital Therapeutics and Mobile-Based Health Management Applications
Independence Blue Cross·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage updated their policy MA12.011d regarding coverage for prescription digital therapeutics and mobile-based health management applications, effective January 1, 2025. This policy change affects how digital health tools and mobile apps prescribed for medical conditions are covered under Medicare Advantage plans.
Action Required
Immediately: Review current digital therapeutic prescriptions and mobile health app recommendations to ensure compliance with updated Medicare Advantage policy MA12.011d. Billing team should verify coverage requirements for any digital therapeutics being prescribed and update prior authorization processes if needed. Contact Medicare Advantage plans directly for specific coverage criteria since only summary information is available.