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Humana Medical Policy Updates – January 2025
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January 2025 Humana Medical Policy Updates:
- Ablation and Extracorporeal Shock Wave Therapy for Musculoskeletal Indications and Soft Tissue Wounds – Medicare Advantage
- Ablation and Extracorporeal Shock Wave Therapy for Musculoskeletal Indications and Soft Tissue Wounds – Medicare Advantage
- Ablation and Extracorporeal Shockwave Therapy for Musculoskeletal Indications and Soft Tissue Wounds
- Achalasia and Gastroesophageal Reflux Disease (GERD) Treatments
- Achalasia and Gastroesophageal Reflux Disease Treatments – Medicare Advantage
- Acne Treatments
- Actinic Keratoses Treatments
- Acupuncture
- Air Ambulance
- Airway Clearance Devices
- Airway Clearance Devices – Medicare Advantage
- Allergy Testing
- Allergy Testing
- Allergy Treatments
- Allograft Transplantation of the Knee
- Allograft Transplantation of the Knee – Medicare Advantage
- Allograft Transplantation of the Knee – Medicare Advantage
- Ambulatory Cardiac Monitoring Devices
- Ambulatory Cardiac Monitoring Devices – Medicare Advantage
- Amtagvi (lifileucel)
- Amtagvi (lifileucel) – Medicare Advantage
- Amtagvi (lifileucel) – Medicare Advantage
- Applied Behavior Analysis
- Artificial Intervertebral Disc Replacement
- Artificial Intervertebral Disc Replacement – Medicare Advantage
- Artificial Intervertebral Disc Replacement – Medicare Advantage
- Athletic Pubalgia Surgery
- Athletic Pubalgia Surgery – Medicare Advantage
- Attention Deficit Hyperactivity Disorder (ADHD) – Diagnosis and Treatment
- Autism Spectrum Disorders Diagnosis and Treatment
- Autism Spectrum Disorders Diagnosis and Treatments – Medicare Advantage
- Autism Spectrum Disorders Diagnosis and Treatments – Medicare Advantage
- Autologous and Allogeneic Bone Marrow Transplants
- Autonomic Nerve Function Testing
- Autonomic Nerve Function Testing – Medicare Advantage
- Bariatric Surgery
- Bariatric Surgery – Medicare Advantage
- Benign Prostatic Hyperplasia Treatments
- Benign Prostatic Hyperplasia Treatments – Medicare Advantage
- Biofeedback
- Blepharoplasty, Blepharoptosis Repair, and Brow Lift
- Blepharoplasty, Blepharoptosis Repair, and Brow Lift – Medicare Advantage
- Blepharoplasty, Blepharoptosis Repair, and Brow Lift – Medicare Advantage
- Bone Density Measurement
- Bone Graft Substitutes
- Bone Graft Substitutes – Medicare Advantage
- Bone Graft Substitutes – Medicare Advantage
- Bone Growth Stimulators
- Brachytherapy
- Brachytherapy – Medicare Advantage
- Brachytherapy – Medicare Advantage
- Brachytherapy – Medicare Advantage
- Breast Excision and Mastectomy – Medicare Advantage
- Breast Imaging
- Breast Imaging – Medicare Advantage
- Breast Reconstruction
- Breast Reconstruction – Medicare Advantage
- Bronchial Thermoplasty
- Bronchial Thermoplasty – Medicare Advantage
- Capsule Endoscopy
- Capsule Endoscopy – Medicare Advantage
- Capsule Endoscopy – Medicare Advantage
- Cardiac Catheterization
- Cardiac Catheterization and Coronary Angiography – Medicare Advantage
- Cardiac Electrophysiological Studies and Cardiac Catheter Ablation
- Cardiac Electrophysiological Studies and Cardiac Catheter Ablation – Medicare Advantage
- Cardiac Electrophysiological Studies and Cardiac Catheter Ablation – Medicare Advantage
- Cardiac Pacemakers – Medicare Advantage
- Cardiac Pacemakers – Medicare Advantage
- Cardiac Pacemakers – Medicare Advantage
- Cardiac Rehabilitation
- Cardiac Single Photon Emission Computed Tomography
- Cardiovascular Disease Risk Testing
- Cardiovascular Nuclear Imaging and Stress Testing – Medicare Advantage
- Cardiovascular Nuclear Imaging and Stress Testing – Medicare Advantage
- Cardioverter Defibrillators/Cardiac Resynchronization Therapy
- Cardioverter Defibrillators/Cardiac Resynchronization Therapy – Medicare Advantage
- Carotid Revascularization
- Carotid Revascularization – Medicare Advantage
- Carotid Revascularization – Medicare Advantage
- Carpal Tunnel Syndrome Surgical Treatments
- Carpal Tunnel Syndrome Surgical Treatments – Medicare Advantage
- Carpal Tunnel Syndrome Surgical Treatments – Medicare Advantage
- Chimeric Antigen Receptor (CAR) T-cell Therapy – Medicare Advantage
- Chimeric Antigen Receptor (CAR) T-cell Therapy – Medicare Advantage
- Chimeric Antigen Receptor (CAR) T-cell Therapy – Medicare Advantage
- Chiropractic Care
- Chronic Vertigo Evaluation and Treatment
- Clinical Trials
- Code Compendium (Cardiovascular)
- Code Compendium (Laboratory)
- Code Compendium (Miscellaneous)
- Code Compendium (Musculoskeletal and Neurologic)
- Code Compendium (Musculoskeletal and Neurologic) – Medicare Advantage
- Code Compendium (Obstetrics -Gynecology)
- Code Compendium (Ophthalmology)
- Code Compendium (Wound Care)
- Cognitive Rehabilitation
- Cold and Heat Therapy Devices – Medicare Advantage
- Cold Therapy Devices/ Heating Devices/ Combined Heat and Cold Therapy Devices
- Colonoscopy and Colorectal Cancer Screening
- Colonoscopy and Colorectal Cancer Screening – Medicare Advantage
- Colonoscopy and Colorectal Cancer Screening – Medicare Advantage
- Colonoscopy and Colorectal Cancer Screening – Medicare Advantage
- Comparative Genomic Hybridization/Chromosomal Microarray
- Complementary and Alternative Medicine
- Comprehensive Genomic Profiling and Genetic Testing for Solid Tumors
- Comprehensive Genomic Profiling and Genetic Testing for Solid Tumors – Medicare Advantage
- Continuous Ambulatory Blood Pressure Monitoring
- Continuous Glucose Monitoring Systems and Insulin Pumps
- Continuous Passive Motion and Mechanical Stretching Devices
- Coronary CT Angiography, Fractional Flow Reserve and Adjunctive Testing
- Coronary CT Angiography, Fractional Flow Reserve with CT and Adjunctive Testing – Medicare Advantage
- Coronary Stents and Angioplasty
- Cosmetic and Reconstructive Surgery
- Cosmetic and Reconstructive Surgery – Medicare Advantage
- Cranial Electrical Stimulation – Medicare Advantage
- Cryoablation
- Cryoablation – Medicare Advantage
- Deep Brain Stimulation and Cortical Brain Stimulation
- Deep Brain Stimulation and Cortical Stimulation – Medicare Advantage
- Diagnostic Esophagogastroduodenoscopy or Esophagascopy (age 59 years or younger)
- Diagnostic Esophagogastroduodenoscopy or Esophagoscopy – Medicare Advantage
- Diagnostic Imaging – Medicare Advantage
- Digital Therapeutics
- Discography
- Drug Testing
- Durable Medical Equipment
- Dynamic Spinal Stabilization Devices
- Dynamic Spinal Stabilization Devices – Medicare Advantage
- Dysphagia Imaging Evaluation – Medicare Advantage
- Early Prostate Cancer Detection – Medicare Advantage
- Elective Aorta and Iliac Artery Aneurysm Repair
- Elective Aorta and Iliac Artery Aneurysm Repair – Medicare Advantage
- Electric Tumor Treatment Fields
- Electrical Stimulation and Electromagnetic Therapy for the Treatment of Wounds
- Electrical Stimulators – Diaphragmatic/Phrenic Nerve, Functional and Neuromuscular
- Electrical Stimulators – Diaphragmatic/Phrenic Nerve, Functional and Neuromuscular – Medicare Advantage
- Electrical Stimulators for Pain and Nausea/Vomiting
- Electrothermal Intradiscal Therapies
- Emerging Tumor Markers for Diagnosis and Monitoring of Cancer
- Endobronchial Valves for Emphysema
- Endobronchial Valves for Emphysema – Medicare Advantage
- Erectile Dysfunction and Peyronie’s Disease Treatments
- Erectile Dysfunction and Peyronie’s Disease Treatments – Medicare Advantage
- Exhaled Breath Tests
- Extended Ophthalmoscopy
- Extraosseous Subtalar Joint implantation and Subtalar Arthroereisis
- Extraosseous Subtalar Joint Implantation and Subtalar Arthroereisis – Medicare Advantage
- Facility Based Sleep Studies – Medicare Advantage
- Fecal Incontinence Evaluation and Treatments
- Fecal Incontinence Evaluation and Treatments – Medicare Advantage
- Fecal Microbiota Transplantation
- Foot Surgical Procedures
- Foot Surgical Procedures – Medicare Advantage
- Fusion Imaging for Cancer Indications
- Fusion Imaging for Cancer Indications – Medicare Advantage
- Fusion Imaging for Noncancer Indications
- Fusion Imaging for Noncancer Indications – Medicare Advantage
- Gastric Pacing/Gastric Electrical Stimulation
- Gastric Pacing/Gastric Electrical Stimulation – Medicare Advantage
- Gastrointestinal Motility Monitoring
- Gender Affirmation Surgery
- Gender Affirmation Surgery – Medicare Advantage
- Gene Expression Profiling for Cancer Indications
- Gene Expression Profiling for Cancer Indications – Medicare Advantage
- Gene Expression Profiling for Noncancer Indications
- Gene Expression Profiling for Noncancer Indications – Medicare Advantage
- Gene Expression Profiling for Prostate Cancer
- Gene Therapy Treatments for Beta Thalassemia
- Gene Therapy Treatments for Beta Thalassemia – Medicare Advantage
- Gene Therapy Treatments for Sickle Cell Disease
- Gene Therapy Treatments for Sickle Cell Disease – Medicare Advantage
- Genetic and Biomarker Testing for Alzheimer Disease
- Genetic and Biomarker Testing for Neurodegenerative Disease – Medicare Advantage
- Genetic and Coagulation Testing for Noncancer Blood Disorders
- Genetic and Coagulation Testing for Noncancer Blood Disorders – Medicare Advantage
- Genetic Testing
- Genetic Testing – Medicare Advantage
- Genetic Testing for Angelman and Prader-Willi Syndrome
- Genetic Testing for Cardiac Conditions
- Genetic Testing for Cardiac Conditions – Medicare Advantage
- Genetic Testing for Carrier Screening
- Genetic Testing for Celiac Disease
- Genetic Testing for Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy Syndrome
- Genetic Testing for Cystic Fibrosis
- Genetic Testing for Diagnosis of Inherited Conditions
- Genetic Testing for Diagnosis of Inherited Conditions – Medicare Advantage
- Genetic Testing for Disease Risk
- Genetic Testing for Ehlers-Danlos Syndrome
- Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders
- Genetic Testing for Hematologic Malignancies and Suspected Myeloid Disorders – Medicare Advantage
- Genetic Testing for Hereditary Ataxias
- Genetic Testing for Hereditary Ataxias – Medicare Advantage
- Genetic Testing for Hereditary Breast, Ovarian, Pancreatic and Prostate Cancer
- Genetic Testing for Hereditary Breast, Ovarian, Pancreatic and Prostate Cancer – Medicare Advantage
- Genetic Testing for Hereditary Cancer
- Genetic Testing for Hereditary Cancer – Medicare Advantage
- Genetic Testing for Hereditary Colorectal and Uterine Cancer
- Genetic Testing for Hereditary Colorectal and Uterine Cancer – Medicare Advantage
- Genetic Testing for Hereditary Peripheral Neuropathies
- Genetic Testing for Marfan Syndrome and Related Conditions
- Genetic Testing for Methylene Tetrahydrofolate Reductase
- Genetic Testing for Muscular Dystrophy and Spinal Muscular Atrophy
- Genetic Testing for Niemann-Pick Disease
- Genetic Testing for RASopathy Syndromes
- Glaucoma Surgical Treatments
- Glaucoma Surgical Treatments – Medicare Advantage
- Gynecomastia Surgery
- Headache and Occipital Neuralgia Treatments
- Headache and Occipital Neuralgia Treatments – Medicare Advantage
- Hematopoietic Stem Cell Transplantation – Medicare Advantage
- Hip Arthroplasty
- Hip Arthroplasty – Medicare Advantage
- Hip, Knee and Shoulder Arthroscopic Surgeries
- Hip, Knee and Shoulder Arthroscopic Surgeries – Medicare Advantage
- Home Births and Birth Doulas
- Home Health
- Home Oximetry Monitoring
- Homologous Recombination Repair Testing and Liquid Biopsy for Prostate Cancer
- Hospital Services (Inpatient, Observation, Long Term Care Hospital) – Medicare Advantage
- Hyperbaric Oxygen Therapy, Topical Oxygen Therapy
- Hyperbaric Oxygen Therapy, Topical Oxygen Therapy – Medicare Advantage
- Hyperhidrosis Treatments
- Hyperthermia for Treatment of Cancer – Medicare Advantage
- Hyperthermia Treatment for Cancer (Local, Regional and Whole Body)
- Immersion Therapy Mattress-Bed – Medicare Advantage
- Implantable and Non-Implantable Hearing Devices
- Implantable Cardiac Devices for Hemodynamic Management – Medicare Advantage
- Implantable Infusion Pumps for Pain or Spasticity
- Implantable Infusion Pumps for Pain or Spasticity – Medicare Advantage
- In Vitro Chemoresistance and Chemosensitivity Assays
- Infertility Evaluation and Treatment
- Infertility Evaluation and Treatments – Medicare Advantage
- Inhaled Nitric Oxide
- Injections for Chronic Pain Conditions
- Injections for Chronic Pain Conditions – Medicare Advantage
- Intensity Modulated Radiation Therapy
- Intensity Modulated Radiation Therapy – Medicare Advantage
- Interspinous Process Decompression Spacers
- Interspinous Process Decompression Spacers – Medicare Advantage
- Intraocular Lens Implants
- Intraoperative Neurological Monitoring
- Intraoperative Neurological Monitoring – Medicare Advantage
- Irreversible Electroporation – Medicare Advantage
- Irreversible Electroporation (NanoKnife)
- Keratoconus Surgical Treatments
- Knee Arthroplasty
- Knee Arthroplasty – Medicare Advantage
- Laboratory Analysis for Prostate Cancer
- Lantidra
- Laparoscopic Hiatal Hernia Repair
- Laser Interstitial Thermal Therapy
- Leadless Cardiac Pacemakers
- Left Atrial Appendage and Cardiac Structural Defect Closure – Medicare Advantage
- Left Atrial Appendage and Cardiac Structural Defect Closure for Stroke Prevention
- Lenmeldy
- Lenmeldy (atidarsagene autotemcel) – Medicare Advantage
- Liquid Biopsy
- Liquid Biopsy – Medicare Advantage
- Low Frequency, Non-Contact, Non-Thermal Ultrasound for Wound Care – Medicare Advantage
- Low Level Laser and High Power Laser Therapy
- Lung Biopsy and Resection – Medicare Advantage
- Lung Cancer Screening
- Lymphedema – Diagnosis and Treatment – Medicare Advantage
- Lymphedema (Diagnosis and Treatment)
- Manipulation Under Anesthesia
- Measurable (Minimal) Residual Disease Testing – Medicare Advantage
- Microwave Thermotherapy
- Microwave Thermotherapy – Medicare Advantage
- Minimally Invasive Sinus and Eustachian Tube Procedures
- Minimally Invasive Sinus and Eustachian Tube Procedures – Medicare Advantage
- Mobility Assistive Devices (Wheelchairs)
- Molecular Biomarkers for Prostate Cancer Risk Stratification – Medicare Advantage
- Molecular Diagnostic Assays and Breath Testing for Transplant Rejection
- Molecular Diagnostic Assays and Breath Testing for Transplant Rejection – Medicare Advantage
- Molecular Diagnostic Testing for Lyme Disease and other Vector Borne Illness
- Molecular Diagnostic Testing for Reproductive Health
- Molecular Markers in Fine Needle Aspirates of Thyroid Nodules
- Molecular Markers in Fine Needle Aspirates of Thyroid Nodules – Medicare Advantage
- Molecular Testing for HLA B27 for Ankylosing Spondylitis
- Multianalyte Assays with Algorithmic Analyses for Cancer Indications
- Multianalyte Assays with Algorithmic Analyses for Cancer Indications – Medicare Advantage
- Multianalyte Assays with Algorithmic Analyses for Noncancer Indications
- Multiplex Pathogen Identification Panels for Infectious Disease
- Multiplex Pathogen Identification Panels for Infectious Disease – Medicare Advantage
- Negative Pressure Wound Therapy
- Negative Pressure Wound Therapy – Medicare Advantage
- Nerve Conduction Testing, Somatosensory and Visual Evoked Potentials, Surface Electromyography
- Neuroablative Techniques for Chronic Pain
- Neuroablative Techniques for Chronic Pain – Medicare Advantage
- Noninvasive Home Ventilators
- Noninvasive Home Ventilators – Medicare Advantage
- Noninvasive Prenatal Testing
- Noninvasive Tests for Hepatic Fibrosis
- Noninvasive Tests for Hepatic Fibrosis – Medicare Advantage
- Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Nonsurgical Treatments
- Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Nonsurgical Treatments – Medicare Advantage
- Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments
- Obstructive Sleep Apnea and Other Sleep Related Breathing Disorders Surgical Treatments – Medicare Advantage
- Ocular Surface Disease Diagnosis and Treatments
- Ocular Surface Disease Diagnosis and Treatments – Medicare Advantage
- Omisirge (omidubicel-onlv)
- Omisirge (omidubicel-onlv) – Medicare Advantage
- Orthognathic Surgery
- Orthognathic Surgery – Medicare Advantage
- Orthotics
- Orthotics – Medicare Advantage
- Osteochondral and Subchondral Defects Surgery
- Osteochondral and Subchondral Defects Surgery – Medicare Advantage
- Outpatient Rehabilitation (Physical Therapy, Occupational Therapy) – Medicare Advantage
- Panniculectomy, Abdominoplasty, Abdominal Contouring
- Percutaneous Coronary Intervention – Medicare Advantage
- Percutaneous Vertebroplasty, Kyphoplasty, Sacroplasty
- Percutaneous Vertebroplasty, Kyphoplasty, Sacroplasty – Medicare Advantage
- Peripheral Artery Disease of the Lower Extremities Angiography, Screening and Exercise Rehabilitation
- Peripheral Artery Revascularization of the Lower Extremities
- Peripheral Artery Revascularization of the Lower Extremities – Medicare Advantage
- Peripheral Nerve Stimulators – Medicare Advantage
- Pharmacogenomic Testing – Medicare Advantage
- Pharmacogenomics – Cytochrome P450 Polymorphisms and VKORC1
- Pharmacogenomics – Noncancer Indications
- Pharmacogenomics and Companion Diagnostics
- Pharmacogenomics and Companion Diagnostics – Medicare Advantage
- Physical Therapy (PT) and Occupational Therapy (OT)
- Plantar Fasciitis Treatments
- Platelet Derived Growth Factors for Wound Healing
- Platelet Rich Plasma for Wound Healing – Medicare Advantage
- Pneumatic Compression Pumps
- Preimplantation Genetic Testing
- Prenatal Invasive Diagnostic Genetic Testing
- Prophylactic Mastectomy
- Prostate Radiation Therapy – Fractionation – Medicare Advantage
- Prostatectomy
- Prostatectomy – Medicare Advantage
- Prosthetics
- Prosthetics – Medicare Advantage
- Proton Beam, Neutron Beam and Carbon Ion Radiation Therapy
- Proton Beam, Neutron Beam and Carbon Ion Radiation Therapy – Medicare Advantage
- Psychiatric Inpatient Hospitalization – Medicare Advantage
- Psychiatric Partial Hospital Program Services – Medicare Advantage
- Pulmonary Rehabilitation
- Radiofrequency Tumor Ablation
- Radiofrequency Tumor Ablation – Medicare Advantage
- Recurrent Pregnancy Loss
- Reduction Mammaplasty
- Reduction Mammaplasty – Medicare Advantage
- Rethymic (allogeneic processed thymus tissue-agdc)
- Rethymic (allogenic processed thymus tissue – agdc) – Medicare Advantage
- Rheumatoid Arthritis: Biologic Markers and Pharmacologic Assessment
- Rheumatoid Arthritis: Biologic Markers and Pharmacologic Assessment – Medicare Advantage
- Rhinoplasty-Septoplasty
- Scanning Computerized Ophthalmic Diagnostic Imaging
- Serological and Fecal Testing for Inflammatory Bowel Disease
- Serological and Fecal Testing for Inflammatory Bowel Disease – Medicare Advantage
- Severe Acute Respiratory Syndrome Coronavirus 2 Serologic (Antibody) Testing
- Severe Acute Respiratory Syndrome Coronavirus 2 Viral Testing
- Shoulder Arthroplasty
- Shoulder Arthroplasty – Medicare Advantage
- Skin and Tissue Substitutes
- Skin and Tissue Substitutes – Medicare Advantage
- Skin Lesion Surveillance Technologies
- Skysona (elivaldogene autotemcel)
- Skysona (elivaldogene autotemcel) – Medicare Advantage
- Sleep Studies, Adults
- Solid Organ Transplants
- Solid Organ Transplants – Medicare Advantage
- Special Stains – Medicare Advantage
- Speech Generating Devices, Voice Prostheses
- Speech Therapy
- Spinal Cord Stimulators
- Spinal Cord Stimulators – Medicare Advantage
- Spinal Decompression Surgery
- Spinal Decompression Surgery – Medicare Advantage
- Spinal Fusion Surgery
- Spinal Fusion Surgery – Medicare Advantage
- Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy
- Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy – Medicare Advantage
- Substance Use Disorder Inpatient Services – Medicare Advantage
- Substance Use Disorder Partial Hospital Program Services – Medicare Advantage
- Support Garments, Fabric
- Tecelra (afamitresgene autoleucel)
- Tecelra (afamitresgene autoleucel) – Medicare Advantage
- Temporomandibular Disorders – Medicare Advantage
- Temporomandibular Joint Disorders
- Thyroid Surgeries (Thyroidectomy & Lobectomy) – Medicare Advantage
- Thyroid Surgeries (Thyroidectomy and Lobectomy)
- Tilt Table Testing
- Tinnitus Treatments
- Tissue Doppler Imaging (Tissue Doppler Echocardiography, Tissue Doppler
- Transcatheter Intravascular Stents
- Transcatheter Peripheral Vascular Stents – Chest, Abdomen and Pelvis – Medicare Advantage
- Transcatheter Valve Procedures
- Transcatheter Valve Procedures – Medicare Advantage
- Transcranial Magnetic Stimulation and Cranial Electrical Stimulation
- Transesophageal and Transthoracic Echocardiography – Medicare Advantage
- Treatment of Achalasia, Gastroesophageal Reflux Disease and Hiatal Hernia – Medicare Advantage
- Ultraviolet Light/Laser Therapy for Skin Conditions – Medicare Advantage
- Ultraviolet Light-Laser Therapy for Skin Conditions
- Urinary Bladder Dysfunction
- Urinary Bladder Dysfunction – Medicare Advantage
- Uterine Fibroid Surgical Treatments
- Uterine Fibroid Surgical Treatments – Medicare Advantage
- Vagus Nerve Stimulation
- Vagus Nerve Stimulation – Medicare Advantage
- Varicose Vein Treatments
- Varicose Vein Treatments – Medicare Advantage
- Ventricular Assist Device Total Artificial Heart
- Ventricular Assist Device, Total Artificial Heart – Medicare Advantage
- Videofluoroscopy, Dynamic MRI for Musculoskeletal Indications
- Videofluoroscopy, Dynamic MRI for Musculoskeletal Indications – Medicare Advantage
- Vitamin D Testing
- Whole Genome/Exome Sequencing and Genome-Wide Association Studies
- Whole Mitochondrial Genome Sequencing and Multigene Panels for Mitochondrial Disorders
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