Medicare AdvantageCoverageMedium impact
MA11.004q, Surgical and Minimally Invasive Treatments for Urinary Outlet Obstruction due to Benign Prostatic Hyperplasia (BPH)
Independence Blue Cross·Urology·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Medicare Advantage updated its policy for surgical and minimally invasive treatments for urinary outlet obstruction due to benign prostatic hyperplasia (BPH). This policy change affects coverage and billing requirements for BPH-related procedures effective January 1, 2026.
Action Required
Before January 1, 2026: Billing team must review the complete MA11.004q policy at the source URL to identify specific changes to BPH procedure coverage, prior authorization requirements, and billing guidelines. Update billing workflows and provider documentation requirements accordingly for all Medicare Advantage plans.