Medicare AdvantageCoverageMedium impact
Treatment of Achalasia, Gastroesophageal Reflux Disease and Hiatal Hernia - Medicare Advantage (Revised)
Humana·Gastroenterology, General Surgery, Bariatric Surgery·Medicare Advantage
Effective date
Mar 2, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage revised their comprehensive policy for treatment of achalasia, GERD, and hiatal hernia, updating coverage determinations for various endoscopic and surgical interventions including POEM, fundoplication procedures, and magnetic sphincter augmentation. The policy provides detailed descriptions of covered treatment options but no specific billing codes are mentioned in the provided excerpt.
Action Required
Before March 2, 2026: Review the complete policy document for specific coverage determinations and coding guidance for achalasia, GERD, and hiatal hernia treatments. Billing team should verify coverage criteria for endoscopic procedures (POEM, Stretta, TIF) and surgical interventions (fundoplication, magnetic sphincter augmentation) to ensure proper authorization and documentation requirements are met.