MedicaidPrior AuthMedium impact
Cardiac Devices - MEDICAID - KENTUCKY (New)
Humana·KY · Cardiology·Medicaid
Effective date
May 13, 2026
We identified it
Jun 24, 2026
Summary
New Medicaid policy for Kentucky establishes coverage criteria for Mobile Cardiac Outpatient Telemetry (MCOT) devices with specific medical indications and requires prior authorization for CPT codes 93228 and 93229.
Action Required
By May 13, 2026: Billing team must update system to require prior authorization for CPT codes 93228 and 93229 for Kentucky Medicaid patients. Ensure providers document that symptoms occur less than once every 48 hours AND either recurrent unexplained syncope or suspected paroxysmal atrial fibrillation as cause of cryptogenic stroke. Claims without prior auth will be denied.