Medicare AdvantageAdministrativeMedium impact
MA00.037m, Billing for Professional Office-Based Services Performed in an Outpatient Office-Based Setting Located within a Facility or on a Facility Campus
Independence Blue Cross·Claims & Billing
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
This policy addresses billing for professional office-based services when performed in outpatient settings located within or on a facility campus. The policy appears to provide guidance on proper billing practices to distinguish between facility-based and office-based services for Medicare Advantage plans.
Action Required
By January 1, 2025: Billing team must review policy MA00.037m to ensure proper billing distinction between office-based services performed in facility settings versus traditional office settings. Verify billing practices align with Medicare Advantage requirements for outpatient office-based services located within or on facility campuses. Update billing procedures to comply with any facility campus billing restrictions outlined in the full policy.