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HumanaMedicare Advantage · Coverage · Medicare Advantage · Pain Management, Neurosurgery, AnesthesiologyHigh impact

Neuroablative Techniques for Chronic Pain - Medicare Advantage (Revised)

Act
immediately
Effective date
Not stated in the notice
Identified
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.

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What to do

immediately · 4 steps
01Billing 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.
02Update billing system, encounter forms, and provider alerts accordingly.
03Do NOT bill neuroablative procedures under Medicare Advantage until the complete policy is reviewed and integrated into your workflow.
04Claims submitted without proper prior authorization or documentation may be denied.

Original notice

Neuroablative Techniques for Chronic Pain - Medicare Advantage (Revised)
mcp.humana.com · Always check the source before changing claims.
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