Medicare AdvantageCoverageMedium impact
Bone Graft Substitutes - Medicare Advantage (Revised)
Humana·Orthopedics, Neurosurgery, General Surgery +1 more·Medicare Advantage
Effective date
Feb 2, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has revised their bone graft substitutes policy, updating coverage criteria for various bone graft materials including autografts, allografts, ceramics, and bone morphogenetic proteins. The policy clarifies that these materials will be covered when used according to FDA-approved indications and medical necessity requirements.
Action Required
Before February 2, 2026: Billing team must review and update bone graft substitute billing procedures to ensure all claims include documentation of FDA-approved indications and medical necessity. Update encounter forms to remind providers that autograft, allograft, and ceramic bone void fillers must meet specific criteria. Verify all bone graft claims are supported by appropriate clinical documentation.