MedicaidCoverageMedium impact
Multi-Function Oscillation Lung Expansion Therapy - MEDICAID - VIRGINIA (New)
Humana·VA · Pulmonology, Critical Care, Internal Medicine +1 more·Medicaid
Effective date
Jul 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicaid in Virginia has established a new policy that does NOT cover Multi-Function Oscillation Lung Expansion (OLE) therapy devices, including both prescription devices like BiWaze Clear System and over-the-counter devices like Acapella. All claims for these services and devices will be denied.
Action Required
Before July 1, 2025: Billing team must update system to automatically deny/not bill HCPCS codes E0469 and E1399 for Humana Medicaid Virginia members when related to Multi-Function Oscillation Lung Expansion therapy. Notify respiratory therapy staff and providers that these devices are not covered. Claims submitted will be denied due to no covered indications.