Payer PolicyActive
Dysphagia Imaging Evaluation - Medicare Advantage
HUMANA-DYSPHAGIA-IMAGING-EVALUATION-MA
Humana
Effective: May 1, 2025
Updated: December 13, 2025
Policy Summary
Covers diagnostic evaluation of dysphagia — including nasopharyngeal laryngoscopy, flexible endoscopic evaluation of swallowing (FEES/FEEST), EGD, CT, and associated skilled therapy services (PT/SLP/OT) furnished in SNF, inpatient, or outpatient settings. Coverage is limited to Medicare‑allowed, medically necessary services as determined by applicable NCDs/LCDs and the Medicare Administrative Contractor for the patient’s jurisdiction; plain x‑rays (including portable x‑rays) are not recommended or considered medically necessary for dysphagia evaluation.
Coverage Criteria Preview
Key requirements from the full policy
"Computed tomography (CT) for the evaluation of dysphagia (see Diagnostic Imaging policy)"
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