Medicare AdvantageCoverageHigh impact
Dynamic Spinal Stabilization and Vertebral Body Tethering for Spinal Deformities - Medicare Advantage (Revised)
Humana·Orthopedics, Neurosurgery, General Surgery·Medicare Advantage
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage will not cover Dynamic Spinal Stabilization or Vertebral Body Tethering procedures effective October 1, 2025, deeming them not medically reasonable and necessary. All related CPT codes will be denied for Medicare Advantage patients.
Action Required
Before October 1, 2025: Billing team must update system to automatically deny/flag CPT codes 22849, 22867, 22868, 22899, 22836, 22837, 22838, 0656T, 0657T, and 0790T for Humana Medicare Advantage patients. Providers must discuss alternative treatment options with patients before the effective date. Claims for these procedures will be denied as not medically necessary.