MedicaidCoverageMedium impact
Inhaled Nitric Oxide - MEDICAID - FLORIDA (Revised)
Humana·FL · Pulmonology, Pediatrics, Cardiology +1 more·Pharmacy
Effective date
Jan 16, 2026
We identified it
Jun 24, 2026
Summary
New Florida Medicaid policy establishes coverage criteria for inhaled nitric oxide (iNO) therapy, limiting coverage to specific pediatric conditions (PPHN in term/near-term infants, postoperative pulmonary hypertension in children with congenital heart disease) and adult vasoreactivity testing for pulmonary arterial hypertension. Coverage excludes preterm infants and congenital diaphragmatic hernia cases.
Action Required
Before January 16, 2026: Billing team must update Florida Medicaid authorization processes for inhaled nitric oxide therapy to ensure compliance with new coverage criteria. Verify patient eligibility against specific requirements: term/near-term infants (≥34 weeks gestation) with PPHN, children with postoperative pulmonary hypertension from congenital heart disease, or adults undergoing vasoreactivity testing. Document absence of congenital diaphragmatic hernia and failure of conventional therapy. Treatment duration limited to 14 days maximum.