Medicare AdvantageCoverageMedium impact
Noninvasive Tests for Hepatic Fibrosis - Medicare Advantage (Revised)
Humana·Gastroenterology, Internal Medicine, Family Medicine +1 more·Medicare Advantage
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established new coverage criteria for noninvasive hepatic fibrosis tests, effective June 1, 2026. The policy covers FIB-4 index testing without restrictions and MRE with specific clinical criteria including chronic liver disease diagnosis or inconclusive FIB-4 results.
Action Required
Before June 1, 2026: Billing team must update prior authorization workflows for CPT 76391 (MRE) to verify patients meet specific criteria including chronic liver disease diagnosis, FIB-4 test results, absence of MRI contraindications, no recent hepatic fibrosis testing within 6 months, and unavailability of VCTE. Update encounter forms to remind providers to document these requirements. Claims not meeting criteria will be denied as not medically necessary.