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Dysphagia Imaging Evaluation - Medicare Advantage (Revised)

Humana·AL, GA, TN, NC, SC, VA, WV · Radiology, Speech Therapy, Gastroenterology +2 more·Medicare Advantage
Effective date
May 1, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage will no longer cover X-rays for dysphagia evaluation effective May 1, 2026. The policy specifically excludes multiple X-ray CPT codes and portable X-ray transport codes as not medically reasonable and necessary for swallowing disorder diagnosis.

Action Required

Action needed
Before May 1, 2026: Billing team must update system to deny X-ray procedures (CPT 70100, 70310, 70360, 71045, 72020, 72040, 91299 and HCPCS R0070, R0075) for dysphagia diagnosis on Humana Medicare Advantage plans. Train providers to use fluoroscopy-based imaging instead. Update encounter forms to reflect coverage limitations. Claims for X-rays related to dysphagia will be denied as not medically necessary.

Affected Billing Codes

70100
70310
70360
71045
72020
72040
91299
R0070
R0075