Medicare AdvantageCoverageMedium impact
Transesophageal and Transthoracic Echocardiography - Medicare Advantage (Revised)
Humana·Cardiology, Cardiothoracic Surgery, Internal Medicine·Medicare Advantage
Effective date
Jun 1, 2026
We identified it
Jun 24, 2026
Summary
Humana has revised their Medicare Advantage policy for transesophageal (TEE) and transthoracic (TTE) echocardiography procedures, updating coverage determinations and medical necessity criteria based on various Medicare Administrative Contractor Local Coverage Determinations. The policy clarifies specific criteria for different TEE/TTE procedures including contrast usage and TEE during cardiac procedures.
Action Required
Before June 1, 2026: Billing team must review and update prior authorization protocols for TEE and TTE procedures to align with updated medical necessity criteria based on applicable Medicare Administrative Contractor jurisdictions. Verify current LCD requirements for each procedure type including contrast usage and ensure documentation supports medical necessity criteria outlined in the revised policy.