Rubrica

Payor

Humana Healthy Horizons in Florida

Rubrica tracks 101 sourced coverage rules across 93 CPT codes for Humana Healthy Horizons in Florida — covering interventional spine, pain management, ortho spine, and orthopedics. Plan type(s): Medicaid. 1-state regional policy (sample: fl).

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101
Sourced rules
93
CPT codes tracked
79
Covered (78%)
76
Prior auth required

Every Rubrica record cites a specific Humana Healthy Horizons in Florida policy document with last-reviewed date and (where available) verbatim source text. Aggregate coverage breakdown by procedure category is shown below; full payor-specific criteria require sign-in.

Coverage by category

Humana Healthy Horizons in Florida's coverage stance across procedure categories tracked in the Rubrica catalog.

CategoryRulesCoveredPrior authInvestigational
Diagnostic141400
Intradiscal8484
Vertebral Augmentation8682
SCS7760
Epidural6660
Facet/MBB6460
Intrathecal Pump6640
HCPCS Drug5150
RFA5451
Botulinum Toxin4440
Interspinous Device4242
PNS4440

Top tracked procedures

First 15 CPT codes in the Humana Healthy Horizons in Florida catalog. Sign in for verbatim criteria, source links, and the rest of the catalog.

CPTProcedureCoverage
62321Interlaminar ESI — Cervical/ThoracicCovered
62323Interlaminar ESI — LumbarCovered
64479TFESI — Cervical/Thoracic (1st level)Covered
64480TFESI — Cervical/Thoracic (add'l level)Covered
64483TFESI — Lumbar/Sacral (1st level)Covered
64484TFESI — Lumbar/Sacral (add'l level)Covered
64490Facet/MBB — Cervical/Thoracic (1st level)Covered
64491Facet/MBB — Cervical/Thoracic (2nd level)Covered
64492Facet/MBB — Cervical/Thoracic (3rd+ level)Not covered
64493Facet/MBB — Lumbar/Sacral (1st level)Covered
64494Facet/MBB — Lumbar/Sacral (2nd level)Covered
64495Facet/MBB — Lumbar/Sacral (3rd+ level)Not covered
64633RFA — Cervical/Thoracic Facet (1st level)Covered
64634RFA — Cervical/Thoracic Facet (add'l level)Covered
64635RFA — Lumbar/Sacral Facet (1st level)Covered
64636RFA — Lumbar/Sacral Facet (add'l level)Covered
27096Sacroiliac Joint Injection (CPT)Covered
64451SI Joint Nerve Block (S1–S3 lateral branches)Not covered
64625SI Joint RFA (lateral branches)Not covered
64624Genicular Nerve RFANot covered
64454Genicular Nerve BlockCovered
63650SCS — Percutaneous TrialCovered
63685SCS — Permanent Implant (IPG)Covered
63661SCS — Lead Revision/Removal (percutaneous)Covered
63688SCS — Generator Revision/RemovalCovered

See every policy for Humana Healthy Horizons in Florida.

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