Humana Claims Payment Policy Update: Robotic and Computer Assisted Surgeries

January 2019 ~

Humana has published a new claim payment policy update for robotic and computer-assisted surgeries.

According to the policy announcement, Humana plans do not separately reimburse for the use of robotic surgical systems and computer-assisted surgical navigation. Use of these technologies is considered integral to the primary procedure.

The insurer provides the following example:

• Humana plans do not reimburse an add-on code billed to report the use of robotic or computer-assisted surgical navigation.
• Reporting an unlisted procedure code for the use of robotic or computer-assisted surgical navigation does not increase the reimbursement received for performing the procedure.
• Billing an increased procedural service modifier only to report the use of robotic or computer-assisted surgical navigation does not increase the reimbursement received for performing the procedure.

Source(s): Humana;