Medicare AdvantageCoverageMedium impact
Ventricular Assist Device, Total Artificial Heart - Medicare Advantage (Revised)
Humana·Cardiology, Cardiothoracic Surgery, Critical Care +1 more·Medicare Advantage
Effective date
Aug 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage updated their policy for Ventricular Assist Devices (VADs) and Total Artificial Hearts (TAH), establishing specific medical necessity criteria for percutaneous VADs and TAH bridge-to-transplant therapy. The policy clarifies coverage requirements and references updated CMS guidelines for these cardiac support devices.
Action Required
By August 1, 2025: Billing team must update prior authorization requirements for VAD and TAH procedures (CPT codes 33975, 33979, 33927, 33990, 33991, 33995) to ensure medical necessity criteria are met before submission. Verify facility credentialing requirements for LVAD procedures and update documentation templates to capture required clinical criteria including FDA approval verification, transplant eligibility status, and specific cardiac conditions.