Medicare AdvantageCoverageHigh impact
Computer Assisted Surgical Navigation for Musculoskeletal Procedures - Medicare Advantage (New)
Humana·KY, OH · Orthopedics, General Surgery·Medicare Advantage
Effective date
Apr 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has issued a new policy effective April 1, 2026, stating that computer-assisted surgical navigation for musculoskeletal procedures will NOT be covered as medically reasonable and necessary. This means claims for these navigation technologies will be denied.
Action Required
Before April 1, 2026: Billing team must update system to flag CPT codes 0054T, 0055T, and 20985 as non-covered for Humana Medicare Advantage plans. Stop billing these codes for computer-assisted surgical navigation procedures for Humana MA members. Update encounter forms to alert providers that these navigation services are not covered. Claims submitted for these codes will be denied as not medically reasonable and necessary.