MedicaidCoverageHigh impact
Injections for Chronic Pain Conditions - MEDICAID - FLORIDA (Revised)
Humana·FL · Pain Management, Anesthesiology, PM&R (Physical Medicine & Rehab) +1 more·Medicaid
Effective date
Jun 22, 2026
We identified it
Jun 24, 2026
Summary
This Humana Florida Medicaid policy establishes comprehensive coverage criteria for chronic pain injection procedures, including epidural steroid injections, trigger point injections, and nerve blocks. It requires 4 weeks of conservative treatment failure before injections are covered and limits the number of injection levels per session.
Action Required
Before June 22, 2026: Billing team must update authorization processes for Humana Florida Medicaid chronic pain injection claims to verify 4 weeks of conservative treatment documentation, ensure proper imaging guidance documentation, and implement session limits (1 level for caudal/interlaminar, max 2 for transforaminal). Update encounter forms to capture required conservative treatment history and radicular pain documentation. Claims without proper documentation will be denied.