Medicare AdvantageCoverageMedium impact
Orthotics - Medicare Advantage (Revised)
Humana·Orthopedics, Physical Therapy, Sports Medicine +1 more·Medicare Advantage
We identified it
Aug 4, 2026
Summary
This is a definitional policy update for Medicare Advantage orthotics coverage. The policy clarifies that orthotics encompasses braces, splints, casts, supports, and other devices used to support, align, prevent, or correct deformities or improve function of movable body parts. This is a recently revised policy (1 day old) that may supersede previous orthotics guidance.
Action Required
Immediately: Billing team and providers should review this revised orthotics definition against current billing practices and prior authorizations. Cross-reference any existing orthotics claims currently being denied or flagged to determine if they align with this updated definition. If the practice has orthotics claims in queue or under review, escalate to management to assess whether reprocessing may be warranted under the revised policy. Monitor for any detailed coverage limitations, prior auth requirements, or code-specific guidance that may be released in the full policy document (this is a summary-only source). Request the complete policy document from Humana to identify specific covered devices, exclusions, and billing code requirements.