MedicaidCoverageMedium impact
Fractional Flow Reserve with Computed Tomography - MEDICAID - OKLAHOMA (Revised)
Humana·OK · Cardiology, Radiology·Medicaid
We identified it
Aug 4, 2026
Summary
Oklahoma Medicaid has updated its policy on Fractional Flow Reserve with Computed Tomography (FFRCT/FFR-CT), a noninvasive diagnostic tool for evaluating coronary artery blood flow in patients with known or suspected coronary artery disease. The policy clarifies that FFR can be obtained from cardiac computed tomography angiography (CCTA) image data. Billing teams must verify coverage requirements, prior authorization mandates, and any specific billing code requirements for this procedure under Oklahoma Medicaid.
Action Required
Immediately: Billing team must obtain the complete policy document (this is a summary only) from the source URL to identify: (1) specific CPT or HCPCS codes for FFRCT/FFR-CT procedures, (2) prior authorization requirements, (3) medical necessity criteria, and (4) coverage limitations. Update billing software rules and provider encounter forms accordingly for Oklahoma Medicaid claims. Do not process FFRCT claims until full policy details are reviewed to avoid denials. Contact Humana Oklahoma Medicaid or your provider representative to clarify effective date and implementation timeline.