Medicare AdvantageCoverageMedium impact
Transcatheter and Device-Based Hemodynamic Management Procedures - Medicare Advantage (Revised)
Humana·Cardiology, Cardiothoracic Surgery, Vascular Surgery +1 more·Medicare Advantage
Effective date
May 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has established new coverage criteria for implantable carotid sinus baroreflex activation therapy for heart failure and confirmed coverage follows CMS guidelines for pulmonary artery pressure sensors and renal denervation procedures. The policy excludes coverage for left atrial pressure monitoring and inferior vena cava hemodynamic monitoring devices.
Action Required
Before May 1, 2026: Billing team must update prior authorization protocols for implantable carotid sinus baroreflex activation therapy (codes 64654-64659, 93145, 93146, C1825) to verify patients meet specific criteria including LVEF ≤35%, NT-proBNP <1600 pg/mL, NYHA Class III/II heart failure, and contraindication screening. Update billing system to flag codes 0933T, 0934T, 0981T, 0982T, 0983T as non-covered for Humana Medicare Advantage. Train staff on CMS NCD requirements for pulmonary artery pressure sensors and renal denervation procedures.