MedicaidCoverageHigh impact
Orthotics - MEDICAID - KENTUCKY (New)
Humana·KY · Orthopedics, PM&R (Physical Medicine & Rehab), Physical Therapy +2 more·Medicaid
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid in Kentucky has established a new comprehensive orthotics policy (HUM-2177-000) defining coverage criteria for various orthotic devices including braces, splints, and supports. The policy specifies medical necessity requirements and covered HCPCS codes for lower extremity, foot, and spine orthotics.
Action Required
Before December 1, 2025: Billing team must update prior authorization and documentation requirements for all listed orthotic HCPCS codes for Kentucky Medicaid patients. Update billing system to flag these codes for medical necessity documentation including detailed clinical descriptions, goniometer measurements for AFOs treating contractures, and specific diagnosis requirements. Train providers on new coverage criteria as claims without proper documentation will be denied.