Medicare AdvantageCoverageMedium impact
Benign Prostatic Hyperplasia Treatments - Medicare Advantage (Revised)
Humana·Urology, General Surgery·Medicare Advantage
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
This is a revised Medicare Advantage policy for Benign Prostatic Hyperplasia (BPH) treatments that will take effect June 1, 2026. The policy provides comprehensive coverage guidelines for various BPH treatment options including surgical therapies, laser treatments, temporary implanted devices, stents, and additional therapies like aquablation and cryosurgery.
Action Required
Before June 1, 2026: Review current BPH treatment billing practices and ensure compliance with updated Medicare Advantage coverage guidelines. Verify that documentation supports medical necessity for all BPH procedures. Check applicable MAC LCD requirements based on practice location for specific treatments like waterjet ablation and laser procedures.