Medicare AdvantageCoverageHigh impact
Neuroablative Techniques for Chronic Pain - Medicare Advantage (Revised)
Humana·Pain Management, Neurosurgery, Anesthesiology·Medicare Advantage
We identified it
Jul 15, 2026
Summary
This is a new Medicare Advantage policy governing coverage of neuroablative techniques for chronic pain management. The policy defines the clinical objectives and methods (including radiofrequency ablation) for denervation procedures. The billing team must obtain the complete policy details to determine specific coverage criteria, prior authorization requirements, and applicable billing codes.
Action Required
IMMEDIATELY: Billing team must obtain the complete policy document from Humana (URL: https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a57c925) to extract: (1) specific CPT/HCPCS codes covered for neuroablative procedures, (2) prior authorization requirements and submission process, (3) medical necessity criteria, (4) effective date, and (5) any bundling or limitation rules. Update billing system, encounter forms, and provider alerts accordingly. Do NOT bill neuroablative procedures under Medicare Advantage until the complete policy is reviewed and integrated into your workflow. Claims submitted without proper prior authorization or documentation may be denied.