This article is for contracted professional and facility providers caring for Medicare Advantage members
As a reminder, our existing Medicare Advantage Management medical policy applies to providers who render services for our Medicare Advantage members.
What’s changing
Starting July 10, 2026, we are aligning how we apply National Coverage Determination (NCD) and Local Coverage Determination (LCD) policies to ensure compliance with CMS regulations.
You may see updated NCD/LCD denial messaging on your provider detail advisories (PDAs) where applicable.
Review our medical policy
Please follow our medical policy 132, Medicare Advantage Management guidelines to avoid claim denials or post-payment recoveries.
In the absence of NCD or LCD guidelines, we adhere to other existing Blue Cross Blue Shield of Massachusetts medical policies.
Questions?
If you have any questions, please call Network Management and Credentialing Services at 1-800-316-BLUE (2583). As always, thank you for caring for our members.
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