MedicaidCoverageMedium impact
Ablation (Cancer and Noncancer Indications) - MEDICAID - MICHIGAN (New)
Humana·MI · Oncology, Urology, Radiology +1 more·Medicaid
Effective date
Jun 17, 2026
We identified it
Jun 24, 2026
Summary
New Medicaid Michigan policy establishes coverage criteria for cryoablation procedures for cancer and non-cancer conditions including bone tumors, kidney cysts, kidney tumors, and liver tumors. Transurethral ultrasound ablation for prostate conditions is specifically excluded from coverage.
Action Required
Before June 17, 2026: Billing team must update Medicaid Michigan coverage rules for ablation procedures. Add prior authorization requirements for bone tumor ablation (20983), kidney procedures (50250, 50541, 50542, 50593), and liver ablation (47371, 47381, 47383) with specific medical necessity criteria. Flag transurethral ultrasound ablation codes (51721, 55881, 55882) as non-covered for prostate conditions. Update encounter forms to include required documentation criteria.