Back to dashboard
Medicare AdvantageCoverageMedium impact

Low Frequency, Non-Contact, Non-Thermal Ultrasound for Wound Care - Medicare Advantage (Revised)

Humana·IA, KS, MO, NE, IN, MI, KY, OH, CA, HI, NV, AK, AZ, ID, MT, ND, OR, SD, UT, WA, WY, AR, CO, NM, OK, TX, LA, MS, DE, DC, MD, NJ, PA, AL, GA, TN, NC, SC, VA, WV, FL · Wound Care, Physical Therapy, Occupational Therapy·Medicare Advantage
Effective date
Jan 3, 2025
We identified it
Jun 24, 2026
Days to comply
—

Summary

Humana Medicare Advantage has established a new policy for low frequency, non-contact, non-thermal ultrasound wound care (CPT 97610), commonly known as MIST Therapy. Coverage follows Medicare Administrative Contractor local coverage determinations with specific medical necessity criteria that vary by geographic jurisdiction.

Action Required

Action needed
Immediately: Review geographic jurisdiction to determine applicable Medicare Administrative Contractor LCD requirements for CPT 97610. Billing team must verify medical necessity criteria based on practice location (different requirements apply in different states). Ensure proper documentation meets the specific LCD criteria for wound care in your jurisdiction before billing for low frequency ultrasound treatments.

Affected Billing Codes

97610

Related policy hubs