Medicare AdvantageCoverageMedium impact
Glaucoma Surgical Treatments - Medicare Advantage (Revised)
Humana·Ophthalmology·Medicare Advantage
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated their glaucoma surgical treatments policy, establishing coverage criteria for minimally invasive glaucoma surgery (MIGS) and related procedures. The policy excludes traditional procedures like trabeculectomy and initial glaucoma drainage device placements from these new criteria.
Action Required
Before June 1, 2026: Billing team must review current glaucoma surgery billing practices and verify coverage criteria compliance for MIGS procedures including canaloplasty, GATT, goniotomy, and aqueous stent placements. Update prior authorization workflows to align with MAC-specific LCD requirements based on practice location. Providers should document medical necessity for refractory glaucoma cases where standard therapies have failed.