Medicare AdvantageBilling CodesMedium 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 Medicare Advantage policy update affects billing for professional services performed in office-based settings located within or on a facility campus. The policy provides updated guidance on proper billing procedures for these hybrid care settings.
Action Required
Before January 31, 2025: Billing team must review current procedures for coding professional services performed in office-based settings located within facilities or on facility campuses. Verify billing practices align with updated Medicare Advantage requirements to ensure proper reimbursement and avoid claim denials.