MedicaidCoverageMedium impact
Prosthetics - MEDICAID - OKLAHOMA (Revised)
Humana·OK · Orthopedics, Plastic Surgery, Ophthalmology +2 more·Medicaid
Effective date
Jan 7, 2026
We identified it
Jun 24, 2026
Summary
This is a comprehensive revision of Humana's Oklahoma Medicaid prosthetics coverage policy, establishing detailed coverage criteria for various prosthetic devices including upper/lower limb prostheses, eye/ear prostheses, and specialized devices like osseointegrated implants. The policy includes specific eligibility requirements and covered HCPCS codes for prosthetic services.
Action Required
By January 7, 2026: Billing team must update prior authorization requirements and coverage criteria for all listed prosthetic codes in billing system for Oklahoma Medicaid patients. Review and update encounter forms to include new eligibility criteria for osseointegrated prostheses (age 22-65, specific contraindications). Train staff on enhanced documentation requirements for prosthetic fittings and test sockets. Ensure medical necessity documentation aligns with new policy criteria to prevent claim denials.