​​​​Starting June 1, 2026, Independence Blue Cross (IBX) and Independence Administrators will implement a new medical policy outlining medical necessity criteria for select elective surgical procedures. These procedures are typically performed in an Ambulatory Surgical Center but may be eligible for coverage in a Hospital Outpatient setting when specific criteria are met. The policy reflects an additional review for site of care during authorization requests for select services. Please refer to the policy documents for the applicable procedure codes.

IBX and Independence Administrators are committed to ensuring members receive care that aligns with medical policy criteria and is delivered in clinically appropriate, safe, and cost-effective settings.

Learn more

Review the following policy notifications, which were published on March 2, 2026:

• Commercial: 12.06.00: Site of Care for Elective Procedures [Hospital Outpatient Setting to Ambulatory Surgical Center (ASC)]​ 

• Medicare Advantage: MA12.005: Site of Care for Elective Procedures [Hospital Outpatient Setting to Ambulatory Surgical Center (ASC)]​
  

Note: The above policy notification links will expire and become unusable on June 1, 2026, when the new policy is issued.

To access the most updated version of any active policy, please refer to the Medical and Claim Payment Policy Portal or simply navigate to the Commercial or Medicare Advantage policy bulletin​s.

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