CommercialAdministrativeMedium impact
00.01.25bu, PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
Independence Blue Cross·PM&R (Physical Medicine & Rehab), Radiology, Diagnostic Imaging·Network
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
This policy establishes new PPO network rules for specialty services including durable medical equipment (DME), laboratory, radiology, and physical medicine/rehabilitation services. The policy appears to define network provider requirements and coverage guidelines for these specialty service categories under commercial PPO plans.
Action Required
Before January 1, 2026: Billing team must review and update network provider lists for DME, laboratory, radiology, and PM&R services. Verify all specialty service providers are in-network under PPO plans. Update billing system to flag out-of-network specialty services that may require patient notifications or different billing procedures.