For physicians, office managers and billing staff

Updated claim payment policies available

A close up of two doctors hands as they look at info on a tablet.

New and revised medical coverage policies available

Humana's medical and pharmacy coverage policies are based on evidence published in peer-reviewed medical literature, technology assessments obtained from independent medical research organizations, evidence-based consensus statements and evidence-based guidelines from nationally recognized professional healthcare organizations.

Information about medical and pharmacy coverage policies can be found at by selecting "Medical and Pharmacy Coverage Policies" under "Resources." Policies can be reviewed by name or revision date.

Users also may search for a particular policy using the search box. More detailed information can be found by reviewing "How to Read a Medical Coverage Policy" and "Understanding the Medical Coverage Policy Development Process" under “Helpful Links.”

Recent changes to medical and pharmacy coverage policies are listed below.

New medical coverage policies

  • Karyotyping for Diagnosis of Noncancer Indications

Policies with Significant Revisions

  • Achalasia and Gastroesophageal Reflux Disease (GERD) Treatments
  • Brachytherapy
  • Breast Reconstruction
  • Comparative Genomic Hybridization/Chromosomal Microarray Analysis
  • Electrical Stimulation (ES) and Electromagnetic Therapy for the Treatment of Wounds
  • Genetic Testing for Diagnosis and Monitoring of Noncancer Indications
  • Genetic Testing for Ehlers Danlos Syndrome
  • Infertility Evaluation and Treatments
  • Keratoconus Surgical Treatments
  • Rhinoplasty/Septoplasty
  • Speech Generating Devices, Voice Prosthesis
  • Transcatheter Valve Procedures

Retired Policies

  • Electroconvulsive Therapy (ECT)