Medicare AdvantageCoverageMedium impact
Interspinous Process Decompression Spacers - Medicare Advantage (Revised)
Humana·Orthopedics, Neurosurgery, Pain Management·Medicare Advantage
Effective date
Nov 3, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage will not cover interspinous process decompression spacers (including Superion/Vertiflex procedures) effective November 3, 2025, determining them not medically reasonable and necessary due to insufficient evidence of clinical benefit.
Action Required
Before November 3, 2025: Billing team must update system to flag CPT codes 22867, 22868, and HCPCS C1821 as non-covered for Humana Medicare Advantage plans. Notify providers that interspinous process decompression spacers (Superion/Vertiflex procedures) will be denied for these patients. Update prior authorization systems to automatically deny requests for these procedures.