MedicaidCoverageMedium impact
Obstructive Sleep Apnea Interventional Therapy - MEDICAID - ILLINOIS (New)
Humana·IL · Sleep Medicine, ENT (Ear, Nose & Throat), Pulmonology·Medicaid
Effective date
May 22, 2026
We identified it
Jun 24, 2026
Summary
Humana Illinois Medicaid has established a new policy explicitly excluding coverage for tongue neuromuscular electrical stimulation devices (like eXciteOSA) and uvulectomy procedures for obstructive sleep apnea treatment. These services are deemed not medically necessary due to insufficient evidence.
Action Required
By May 22, 2026: Billing team must update systems to flag and deny claims for tongue neurostimulation devices (E0490, E0491, E0492, E0493) and uvulectomy (42140) for Humana Illinois Medicaid members with OSA diagnoses. Update encounter forms to alert providers these services are not covered. Claims submitted will be denied as not medically necessary.