Medium impact
Skin and Tissue Substitutes - Medicare Advantage (Revised)
Humana·Effective Sep 1, 2026
Humana Medicare Advantage updated its Skin and Tissue Substitutes coverage policy (Policy HUM-1208-012) effective September 1, 2026. The policy establishes medical necessity criteria and coverage guidelines for bioengineered skin and tissue substitutes (CTPs) across multiple product types, including allogeneic matrices, composite matrices, acellular matrices, and human skin allografts. Billing teams must verify that all skin substitute claims align with specific HCPCS codes and documented indications (breast reconstruction, diabetic foot ulcers, venous leg ulcers, or burns) per the referenced LCDs.