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Temporomandibular Disorders - MEDICAID - FLORIDA (New)
Effective date
Jun 22, 2026
Identified
Jun 24, 2026
Summary
Humana Medicaid Florida has established a new policy for temporomandibular disorder (TMD) procedures, defining specific coverage criteria for CPT codes 21050 and 21070. Coverage requires documented symptoms, minimum 4 weeks of conservative treatment failure, and clinical evidence of internal derangement or specific TMJ conditions.
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What to do
Action · 3 steps
01Before June 22, 2026: Update prior authorization requirements for CPT 21050 and 21070 for Humana Medicaid Florida members.
02Ensure documentation includes specific TMD symptoms, proof of minimum 4 weeks conservative treatment failure, and clinical evidence of internal derangement.
03Train providers on new coverage criteria to prevent claim denials.
Codes mentioned
2105021070
Original notice
Temporomandibular Disorders - MEDICAID - FLORIDA (New)
mcp.humana.com · Always check the source before changing claims.
Related changes
See all Humana changes →Temporomandibular Disorders - Medicare Advantage (Revised)MediumEffective Feb 2, 2026 · Medicare AdvantageTemporomandibular Disorders - MEDICAID - MICHIGAN (New)MediumEffective May 22, 2026 · MedicaidTemporomandibular Disorders - MEDICAID - SOUTH CAROLINA (New)MediumEffective May 25, 2026 · MedicaidTemporomandibular Disorders - MEDICAID - VIRGINIA (New)MediumEffective May 27, 2026 · MedicaidBrowse every Humana change in the policy list