MedicaidCoverageMedium impact
Fractional Flow Reserve with Computed Tomography - MEDICAID - OKLAHOMA (New)
Humana·OK · Cardiology, Radiology·Medicaid
We identified it
Jul 22, 2026
Summary
Oklahoma Medicaid has established a new coverage policy for Fractional Flow Reserve with Computed Tomography (FFR-CT), a noninvasive diagnostic test used to evaluate coronary artery blood flow in patients with known or suspected coronary artery disease. This policy defines coverage for FFR-CT imaging when derived from cardiac computed tomography angiography (CCTA) data.
Action Required
Immediately: Billing team must review the complete FFR-CT policy on the Humana portal (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a586047) to identify specific CPT/HCPCS codes, prior authorization requirements, medical necessity criteria, and reimbursement rates. Once full policy details are obtained, update billing software rules, encounter forms, and provider documentation templates accordingly. Contact Humana directly to confirm effective date and implementation timeline. Do not bill FFR-CT services until the complete policy requirements are documented in your billing system.