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Medical Policy

Terms and Conditions

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  • The Policy Bulletins on this website were developed to assist Independence Blue Cross (“IBC”) in administering the provisions of benefits plans and do not constitute medical advice. If members have a specific question about their medical condition, they should consult with their provider.
  • The Policy Bulletins do not describe benefits, and they do not guarantee coverage of services or guarantee payment. If you are an IBC member, please refer to your specific benefit plan documents for the terms, conditions, limitations, and exclusions of your coverage. Benefits may vary based on the type of program (HMO, PPO, or other) as well as the benefit design selected by an employer or group (i.e., health and welfare fund, school district).
  • IBC makes decisions on coverage considering the Policy Bulletins, benefit plan documents, and the member’s medical history and condition. IBC also may consider applicable laws and regulations as well as standards of regulatory agencies, such as URAQ/NCQA.
  • Coverage for certain services may be required by the Centers for Medicare and Medicaid Services (“CMS”).
  • The Policy Bulletins describe the status of medical technology at the time the Bulletins were developed. Since that time, new technology may have emerged or new medical literature may have been published.
  • These materials contain Current Procedural Terminology (CPT®). All rights reserved. CPT is a registered trademark of the American Medical Association.
  • These materials contain Current Dental Terminology (CDT©). All rights reserved. CDT is a trademark of the American Dental Association.

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