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Injections for Chronic Pain Conditions - MEDICAID - SOUTH CAROLINA (Revised)
Act
by Jan 1, 2025
Effective date
Jan 1, 2025
Identified
Jun 24, 2026
Summary
This is a new Humana Medicaid policy for South Carolina establishing coverage criteria for chronic pain injection procedures including epidural steroid injections, sacroiliac joint injections, and trigger point injections. The policy requires 4 weeks of conservative treatment failure before injections are covered and limits the number of injection levels per session.
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What to do
by Jan 1, 2025 · 3 steps
01Billing team must verify all chronic pain injection claims for Humana Medicaid SC members meet new coverage criteria including 4 weeks of documented conservative treatment failure and radicular pain.
02Update authorization workflows to limit caudal/interlaminar injections to 1 nerve root level per session and transforaminal injections to maximum 2 per session.
03Ensure real-time imaging guidance is documented as integral to procedure.
Codes mentioned
62320623216232364479644806448364484
Original notice
Injections for Chronic Pain Conditions - MEDICAID - SOUTH CAROLINA (Revised)
mcp.humana.com · Always check the source before changing claims.
Related changes
See all Humana changes →Injections for Chronic Pain Conditions - MEDICAID - OKLAHOMA (Revised)HighEffective Jul 29, 2026 · MedicaidInjections for Chronic Pain Conditions - MEDICAID - KENTUCKY (Revised)HighEffective Jul 15, 2026 · MedicaidInjections for Chronic Pain Conditions - MEDICAID - OKLAHOMA (New)HighEffective Jan 7, 2026 · MedicaidInjections for Chronic Pain Conditions - MEDICAID - MICHIGAN (New)HighEffective May 22, 2026 · MedicaidBrowse every Humana change in the policy list