Medicare AdvantageCoverageMedium impact
Breast Imaging - Medicare Advantage (Revised)
Humana·Radiology, Oncology·Medicare Advantage
We identified it
Jun 30, 2026
Summary
This is a 1-day-old Medicare Advantage policy clarifying coverage for breast imaging services across multiple modalities (mammography, digital breast tomosynthesis, MRI, ultrasound) for both screening in asymptomatic individuals and diagnostic imaging when signs/symptoms are present. The policy distinguishes between screening breast cancer (based on age, family history, risk factors) and diagnostic imaging (for symptomatic presentation or personal history of breast cancer). No specific billing code changes, prior authorization requirements, or coverage restrictions are detailed in this summary-only version.
Action Required
Immediately: Billing team should obtain the complete policy document from the source URL to identify specific billing codes, prior authorization requirements, medical necessity criteria, and any coverage limitations. Until full policy details are available, continue current breast imaging billing practices. Flag this policy for follow-up review once the complete version (not summary-only) is published to determine if workflow or documentation changes are needed. Contact Humana MA plan liaison to confirm effective date and implementation timeline.