Medicare AdvantageAdministrativeMedium impact
MA00.010av, 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
Medicare Advantage PPO network rules have been updated for specialty services including durable medical equipment, laboratory, radiology, and physical medicine/rehabilitation services, effective January 1, 2026. This policy change affects network provider requirements and service delivery rules for these specialty areas.
Action Required
Before January 1, 2026: Billing team must review the full policy details at the provided URL to understand specific network rule changes for DME, lab, radiology, and PM&R services. Update billing workflows and provider networks accordingly based on the complete policy requirements.