Medicare AdvantageReimbursementMedium impact
MA09.009z, Reimbursement for Radiopharmaceutical Agents
Independence Blue Cross·Nuclear Medicine, Diagnostic Imaging, Radiology +2 more·Claims & Billing
Effective date
Oct 1, 2025
We identified it
Jun 19, 2026
Summary
Medicare Advantage updated their reimbursement policy for radiopharmaceutical agents, effective October 1, 2025. This change affects billing and reimbursement procedures for nuclear medicine procedures and diagnostic imaging that use radioactive pharmaceutical compounds.
Action Required
By October 1, 2025: Billing team must review and update reimbursement procedures for radiopharmaceutical agents under Medicare Advantage plans. Contact Medicare Advantage representatives to obtain specific billing requirements and fee schedule changes. Update billing software with new reimbursement rates if applicable.