MedicaidCoverageHigh impact
Injections for Chronic Pain Conditions - MEDICAID - MICHIGAN (New)
Humana·MI · Pain Management, Orthopedics, Anesthesiology·Medicaid
Effective date
May 22, 2026
We identified it
Jun 24, 2026
Summary
New Humana Medicaid policy for Michigan establishes coverage criteria for chronic pain injections including epidural steroid injections, sacroiliac joint injections, and trigger point injections. Requires 4 weeks of failed conservative treatment and specific imaging guidance, with limits on number of injections per session and timing between procedures.
Action Required
Before May 22, 2026: Pain management and orthopedic providers must update documentation requirements for Humana Medicaid Michigan members receiving chronic pain injections. Ensure 4 weeks of conservative treatment (activity modification, NSAIDs, physical therapy) is documented before billing CPT 62321 or 62323. Update billing system to enforce injection limits: maximum 1 nerve root level per session for caudal/interlaminar approaches, maximum 2 injections per session for transforaminal approaches. Require real-time imaging guidance documentation. Claims without proper documentation will be denied.