Medicare AdvantageCoverageMedium impact
Percutaneous Vertebroplasty, Kyphoplasty, Sacroplasty - Medicare Advantage (Revised)
Humana·Orthopedics, Neurosurgery, Radiology +1 more·Medicare Advantage
Effective date
Feb 2, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has updated its policy for percutaneous vertebroplasty, kyphoplasty, and sacroplasty procedures, clarifying coverage criteria based on geographic jurisdictions and explicitly stating that sacroplasty will not be considered medically reasonable and necessary. The policy consolidates coverage determinations across different Medicare Administrative Contractor regions.
Action Required
Before February 2, 2026: Billing team must update system to deny sacroplasty procedures (codes 0200T, 0201T) for all Humana Medicare Advantage plans as they will not be covered. For vertebroplasty/kyphoplasty procedures (22510-22515, C7507, C7508), verify coverage criteria based on your MAC jurisdiction using the specific LCD referenced in the policy. Update encounter forms to alert providers that sacroplasty is not covered.