CPT 0970T
medically necessary mastectomies for breast cancer) Simple mastectomy and gynecomastia surgery (excludes radical and modified) Evolent (formerly New Century Health )
Humana · Medicare · ALL
Yes — Prior Auth Required
Documents Needed
- •Clinical notes
Clinical Criteria
medically necessary mastectomies for breast cancer) Simple mastectomy and gynecomastia surgery (excludes radical and modified) Evolent (formerly New Century Health )
Source
Found in: Humana 2026 Medicare Prior Authorization List
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