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MedicaidCoverageMedium impact

Obstructive Sleep Apnea Interventional Therapy - MEDICAID - VIRGINIA (New)

Humana·VA · Sleep Medicine, ENT (Ear, Nose & Throat), General Surgery·Medicaid
Effective date
May 27, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Virginia Medicaid has established a new policy that explicitly excludes coverage for nonsurgical neuromuscular electrical stimulation of the tongue muscle (including eXciteOSA devices) and uvulectomy procedures for treating obstructive sleep apnea. These services are deemed non-covered due to insufficient evidence of clinical effectiveness.

Action Required

Action needed
Before May 27, 2026: Billing team must update system to flag CPT 42140 and HCPCS codes E0490, E0491, E0492, E0493 as non-covered for Virginia Medicaid members. Update encounter forms to alert providers that these OSA interventional therapies are excluded. Claims for these services will be denied for Humana Virginia Medicaid patients.

Affected Billing Codes

E0490
E0491
E0492
E0493
42140