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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

Review for Readmission, PDF

Doula Services, PDF

EPSDT Personal Care Services (PCS) Clinical Coverage Policy, PDF

Chisholm Policy, PDF

Covered Benefits and Services Policy , PDF

Abortion Hysterectomy and Sterilization Policy, PDF

Timeliness of UM Determinations and Notifications Policy , PDF

Louisiana Utilization Management Program Description, PDF

UM Program Description Policy- Description, PDF

Continuity of Care and Care Transitions, PDF

MD Review, PDF

Observation Policy, PDF

Bariatric Surgery Clinical Coverage Policy, PDF

Blepharoplasty, Blepharoptosis Repair and Brow Lift Clinical Coverage Policy, PDF

Breast Surgery Clinical Coverage Policy, PDF

Cochlear Implant Clinical Coverage Policy, PDF

Continuous Subcutaneous Insulin External Infusion Pump Clinical Coverage Policy, PDF

Gender Affirmation Surgery Clinical Coverage Policy, PDF

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

Hearing Aids Clinical Coverage Policy, PDF

High Frequency Chest Wall Oscillation Devices Clinical Coverage Policy, PDF

Home Health Clinical Coverage Policy, PDF

Hospice Clinical Coverage Policy , PDF

Hospital Bed Clinical Coverage Policy, PDF

Inhaled Nitric Oxide Clinical Coverage Policy, PDF

Intrathecal Baclofen Therapy Clinical Coverage Policy, PDF

Molecular Diagnostic Assays and Breath Testing for Transplant Rejection Clinical Coverage Policy, PDF

Osteogenic Bone Growth Stimulators Clinical Coverage Policy, PDF

Pediatric Day Health Care (PDHC) Clinical Coverage Policy, PDF

Wheelchair, Wheelchair Repairs, Standing Frame, Patient Lifts Clinical Coverage Policy, PDF

Wound Care Clinical Coverage Policy, PDF

Behavioral health coverage policies

Applied Behavioral Analysis Clinical Coverage, PDF

Crisis Intervention — Follow Up Policy, PDF

Assertive Community Treatment Policy, PDF

Individual Placement and Support Policy , PDF

Multi Systemic Therapy Policy, PDF

Functional Family Therapy Clinical Coverage Policy, PDF

Permanent Supportive Housing (PSH) Services, PDF

Utilization of LOCUS/CALOCUS Clinical Review Criteria, PDF

Therapeutic Group Therapy, PDF

Community Brief Crisis Support (CBCS), PDF

Crisis Stabilization for Children and Adolescents , PDF

Personal Care Services (PCS) for Adults with Serious Mental Illness (SMI) Clinical Coverage Policy , PDF

Crisis Stabilization for Adults Coverage Policy , PDF

Community Psychiatric Support and Treatment (CPST) and Psychosocial Rehabilitation (PSR) , PDF

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Documents and forms

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