MedicaidCoverageMedium impact
Medical Supplies, Equipment and Appliances Durable Medical Equipment - MEDICAID - VIRGINIA (New)
Humana·VA · Family Medicine, General Practice, Internal Medicine +4 more·Medicaid
Effective date
Jul 1, 2025
We identified it
Jun 24, 2026
Summary
New Humana Virginia Medicaid policy establishes coverage criteria for durable medical equipment (DME) and medical supplies, effective July 1, 2025. The policy defines specific coverage requirements, rental vs. purchase decisions, and lists covered/non-covered equipment with corresponding HCPCS codes.
Action Required
Before July 1, 2025: Billing team must update Virginia Medicaid DME billing procedures to ensure all equipment meets the 4-part DME definition (withstands repeated use, not useful without illness, appropriate for home use, serves medical purpose). Verify practitioner prescriptions are on file and equipment meets basic functional needs. Update billing system to flag duplicate equipment requests as non-covered. Train staff on rental vs. purchase coverage rules where Plan determines cost-effectiveness.