Medicare AdvantageCoverageMedium impact
Cardiovascular Nuclear Imaging and Stress Testing - Medicare Advantage (Revised)
Humana·Cardiology, Nuclear Medicine, Radiology·Medicare Advantage
Effective date
May 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated their cardiovascular nuclear imaging and stress testing policy, establishing new coverage criteria for cardiac SPECT, PET, and stress testing procedures. The policy provides jurisdiction-specific guidance using various Local Coverage Determinations and applies standardized medical necessity criteria across different geographic regions.
Action Required
Before May 1, 2026: Billing team must review current cardiovascular nuclear imaging and stress testing procedures to ensure compliance with jurisdiction-specific LCD requirements. Update pre-authorization workflows to align with the medical necessity criteria specified in LCD L35083 for jurisdictions without specific LCDs. Verify proper documentation requirements for cardiac SPECT, PET, and stress testing claims to prevent denials.