Notification of Medicare Medical Coverage Policies Revisions June 28, 2024

Medical Policy Name	Summary of Changes
Investigational (Experimental) Services	I. Annual Review Medicare Claims Processing Manual 100-4 Chp 32 sections 68 & 69 Medicare Managed Care Manual Chp 4 section 10.7.2, section 20 & 90.5 CMS Manual System: Pub 100-02 Transmittal 198, Change Request 8921 MLN Matters MM8921 Blue Medicare “Evidence of Coverage”, 2023; Chapter 4: Medical Benefits Chart (What is covered and what you pay), Section 3.1- Services we do not cover (exclusions) BCBSNC Corporate Medical Coverage Policy: Investigational (Experimental) Services Social Security; Exclusions from Coverage II. Link under “Applicable Codes” updated. Minor Revisions only.

Medical Policy Name

Summary of Changes

Investigational (Experimental) Services

I. Annual Review

Medicare Claims Processing Manual 100-4 Chp 32 sections 68 & 69

Medicare Managed Care Manual Chp 4 section 10.7.2, section 20 & 90.5

CMS Manual System: Pub 100-02 Transmittal 198, Change Request 8921

MLN Matters MM8921

Blue Medicare “Evidence of Coverage”, 2023; Chapter 4: Medical Benefits Chart (What is covered and what you pay), Section 3.1- Services we do not cover (exclusions)

BCBSNC Corporate Medical Coverage Policy: Investigational (Experimental) Services

Social Security; Exclusions from Coverage

II. Link under “Applicable Codes” updated. Minor Revisions only.

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