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MedicaidCoverageMedium impact

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

Humana·IN · ENT (Ear, Nose & Throat), Sleep Medicine·Medicaid
Effective date
May 20, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Indiana Medicaid has issued a new policy explicitly stating that uvulectomy procedures (CPT 42140) for treating obstructive sleep apnea are NOT covered and considered not medically necessary. This policy establishes clear non-coverage for this interventional therapy approach to OSA treatment.

Action Required

Action needed
Before May 20, 2026: Billing team must update system to flag CPT 42140 (uvulectomy) as non-covered for Humana Indiana Medicaid members when billed for OSA treatment. Train providers that this procedure will not be reimbursed for sleep apnea indications. Update prior authorization systems to automatically deny requests for this code/indication combination.

Affected Billing Codes

42140