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Clinical coverage policies

Clinical coverage guidelines are resources for physicians and other Humana-contracted healthcare professionals providing care to our members enrolled in Humana Healthy Horizons® in Louisiana. Humana Healthy Horizons has adopted the following clinical coverage policies:

provider viewing policies on tablet

Bariatric Surgery Clinical Coverage Policy – Jan. 12, 2023, PDF

Blepharoplasty, Blepharoptosis Repair and Brow Lift Clinical Coverage Policy – Jan. 12, 2023, PDF

Breast Surgery Clinical Coverage Policy – Jan. 12, 2023, PDF

Cochlear Implant Clinical Coverage Policy – Jan. 12, 2023, PDF

Continuous Subcutaneous Insulin External Infusion Pump Clinical Coverage Policy – Jan. 12, 2023, PDF

Gender Affirmation Surgery Clinical Coverage Policy – Jan. 12, 2023, PDF

Genetic Testing for Breast and Ovarian Cancer, Familial Adenomatous Polyposis (FAP) and Lynch Syndrome Clinical Coverage Policy – Jan. 12, 2023, PDF

Hearing Aids Clinical Coverage Policy – Jan. 12, 2023, PDF

High Frequency Chest Wall Oscillation Devices Clinical Coverage Policy – Jan. 12, 2023, PDF

Home Health Clinical Coverage Policy – Jan. 12, 2023, PDF

Hospice Clinical Coverage Policy – Jan. 12, 2023, PDF

Hospital Bed Clinical Coverage Policy – Jan. 12, 2023, PDF

Inhaled Nitric Oxide Clinical Coverage Policy – Jan. 12, 2023, PDF

Intrathecal Baclofen Therapy Clinical Coverage Policy – Jan. 12, 2023, PDF

Molecular Diagnostic Assays and Breath Testing for Transplant Rejection Clinical Coverage Policy – Jan. 12, 2023, PDF

Osteogenic Bone Growth Stimulators Clinical Coverage Policy – Jan. 12, 2023, PDF

Pediatric Day Health Care (PDHC) Clinical Coverage Policy – Jan. 12, 2023, PDF

Personal Care Services (PCS) Clinical Coverage Policy – Jan. 12, 2023, PDF

Wheelchair, Wheelchair Repairs, Standing Frame, Patient Lifts Clinical Coverage Policy – Jan. 12, 2023, PDF

Wound Care Clinical Coverage Policy – Jan. 12, 2023, PDF

Behavioral health coverage policies

Crisis Stabilization for Adults Coverage Policy – April 9, 2023, PDF

Mental Health Rehabilitation Services – Community Psychiatric Support and Treatment (CPST) and Psychosocial Rehabilitation (PSR) Coverage Policy – April 1, 2023, PDF

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Documents and forms

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