MedicaidCoverageMedium impact
Ablation (Cancer and Noncancer Indications) - MEDICAID - ILLINOIS (New)
Humana·IL · Oncology, General Surgery, Radiology·Medicaid
Effective date
Jun 17, 2026
We identified it
Jun 24, 2026
Summary
New Illinois Medicaid policy establishes coverage criteria for cryoablation procedures for bone and liver tumors. Coverage is approved for specific indications including osteoid osteomas, skeletal metastases with certain criteria, and hepatocellular carcinoma under 3cm or small metastatic liver tumors.
Action Required
Before June 17, 2026: Billing team must update systems to reflect new Illinois Medicaid coverage criteria for cryoablation procedures. Document specific medical indications (osteoid osteomas, skeletal metastases with fracture risk/hormone secretion/pain, hepatocellular carcinoma <3cm, small liver metastases) for CPT codes 20983, 47371, 47381, and 47383. Update prior authorization processes to verify coverage criteria are met before procedures.