Back to dashboard
Medicare AdvantageCoverageMedium impact

Nerve Stimulation for Urinary Incontinence - Medicare Advantage (Revised)

Humana·Urology, Neurology, OB-GYN·Medicare Advantage
Effective date
Apr 1, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Medicare Advantage updated coverage criteria for nerve stimulation procedures treating urinary incontinence, including sacral nerve stimulation and posterior tibial nerve stimulation. The policy establishes specific medical necessity criteria for implantation, removal, and replacement of these devices.

Action Required

Action needed
Before April 1, 2026: Billing team must review medical necessity documentation requirements for nerve stimulation procedures (sacral nerve stimulation and posterior tibial nerve stimulation) for Medicare Advantage patients. Update billing workflows to ensure FDA-approved devices are documented and contraindications are ruled out. Verify proper coding for implantation, removal, and replacement procedures according to new coverage criteria.

Affected Billing Codes

64561
64581
64590
C1767
C1787
L8683
64566
64595