Humana expands coverage for SI joint fusion procedures

Alan Condon -   Print  | Email

Humana has widened its coverage policies to include minimally invasive sacroiliac joint fusion using triangular titanium implants, which covers SI-Bone's iFuse system.

Four things to know:

1. The payer's revised policy, effective Dec. 10, covers MIS SI joint fusion for chronic low back pain due to SI joint dysfunction, provided certain criteria are met.

2. Humana joins 36 other health plans that cover MIS SI joint fusion using iFuse. Other payers include Aetna, Cigna and United Healthcare.

3. Almost 50,000 cases have been performed with iFuse over the past 10 years, according to SI-Bone.

4. CMS on Jan. 1, 2020, increased the reimbursement rate for MIS SI joint fusion by 27 percent. Surgeon pay for the procedure rose from $720 to $915 this year, leading more payers and device companies to take a closer look at the MIS SI joint space.

Click here to view Humana's revised coverage policy for spinal fusion.

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