MedicaidPrior AuthMedium impact
Neurostimulators - MEDICAID - KENTUCKY (New)
Humana·KY · Neurosurgery, Neurology, Pain Management·Medicaid
Effective date
Jul 22, 2026
We identified it
Jul 21, 2026
Summary
Humana Kentucky Medicaid has established a new coverage policy for intracranial neurostimulator electrodes, effective 07/22/2026. The policy covers implantation of cerebral/cortical neurostimulator electrodes (CPT 61850, 61860) and removal/revision procedures (CPT 61880) when medically necessary. Prior authorization is required for all covered procedures. For members under age 21, requests must meet EPSDT requirements.
Action Required
By 07/22/2026: Billing team must implement prior authorization requirement for CPT codes 61850, 61860, and 61880 in the billing system for Humana Healthy Horizons Kentucky Medicaid members. Update all claim submission workflows to require prior authorization submission before processing claims for these neurostimulator electrode procedures. Configure system to flag claims for members under age 21 for EPSDT compliance review. Train billing staff and providers on the requirement that prior auth must be obtained before service delivery. Failure to obtain prior authorization will result in claim denials.