Medicare AdvantageCoverageMedium impact
Prosthetics - Medicare Advantage (Revised)
Humana·Orthopedics, Plastic Surgery, PM&R (Physical Medicine & Rehab) +1 more·Medicare Advantage
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Summary
This is a comprehensive revision of Humana's Medicare Advantage prosthetics policy, providing detailed coverage guidance for various prosthetic devices including upper/lower limb prostheses, breast prostheses, eye prostheses, and emerging technologies like osseointegrated prostheses. The policy references multiple CMS sources and MAC jurisdictions for coverage determinations.
Action Required
By December 1, 2025: Review and update prosthetics billing procedures to align with revised Humana Medicare Advantage policy HUM-1194-008. Ensure staff are familiar with coverage requirements for different prosthetic types (body powered, myoelectric, hybrid, passive, osseointegrated). Verify appropriate CMS LCD/NCD references are being followed based on MAC jurisdiction. Update prior authorization processes if needed for prosthetic devices.