MedicaidCoverageMedium impact
Ablation (Cancer and Noncancer Indications) - MEDICAID - SOUTH CAROLINA (New)
Humana·SC · Oncology, Urology, General Surgery +1 more·Medicaid
Effective date
Jun 17, 2026
We identified it
Jun 24, 2026
Summary
Humana has published a new Medicaid policy for South Carolina covering cryoablation procedures for cancer and noncancer conditions including bone tumors, kidney cysts, kidney tumors, and liver tumors. This establishes coverage criteria and billing codes for various ablation procedures that were previously undefined.
Action Required
Before June 17, 2026: Review and implement the new coverage criteria for cryoablation procedures. Billing team must update system to verify medical necessity requirements for each indication (bone tumors require osteoid osteomas or specific metastases criteria, kidney cysts require Category III/IV classification, kidney tumors require biopsy confirmation and staging criteria, liver tumors require size and location specifications). Update encounter forms to prompt providers for required documentation elements.