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MedicaidPrior AuthMedium impact

Psychoeducation - MEDICAID - KENTUCKY (Revised)

Humana·KY · Psychiatry·Medicaid
Effective date
Mar 24, 2026
We identified it
Jun 24, 2026
Days to comply

Summary

Humana Kentucky Medicaid has established new coverage criteria and limitations for psychoeducation services (HCPCS H2027). The policy requires prior authorization and limits coverage to 20 units (5 hours) per benefit plan year with specific documentation requirements.

Action Required

Action needed
Before March 24, 2026: Billing team must implement prior authorization requirements for HCPCS H2027 psychoeducation services for Humana Kentucky Medicaid members. Update billing system to enforce 20 unit annual limit and ensure documentation includes detailed treatment plans with recovery goals, family involvement, and transition planning. Claims without prior auth or exceeding limits will be denied.

Affected Billing Codes

H2027