Medicare AdvantageCoverageMedium impact
Orthotics - Medicare Advantage (Revised)
Humana·Orthopedics, PM&R (Physical Medicine & Rehab), Physical Therapy +2 more·Medicare Advantage
Effective date
Oct 1, 2025
We identified it
Jun 24, 2026
Summary
Humana has revised its Medicare Advantage orthotics policy effective October 1, 2025, providing updated coverage guidelines for various orthotic devices including braces, splints, and advanced devices like dynamic exoskeleton braces and microprocessor-controlled orthoses. The policy references specific Medicare Administrative Contractor Local Coverage Determinations that providers must follow.
Action Required
Before October 1, 2025: Billing team must review and update orthotics billing procedures to align with referenced Medicare Administrative Contractor Local Coverage Determinations (LCDs) based on practice geographic location. Verify current LCD requirements for ankle-foot/knee-ankle-foot orthoses (L33686), knee orthoses (L33318), and spinal orthoses (L33790). Ensure documentation meets standard requirements outlined in LCA A55426 for all DME MAC jurisdictions.