MedicaidPrior AuthMedium impact
Daxxify® (daxibotulinumtoxinA-lanm) (Revised)
Humana·OH · Neurology, PM&R (Physical Medicine & Rehab), Pain Management·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicaid Ohio has implemented new prior authorization requirements for Daxxify (daxibotulinumtoxinA-lanm) for cervical dystonia treatment, requiring patients to be 18+ and have failed previous treatment with Dysport or Xeomin. The policy excludes coverage for cosmetic uses and numerous other conditions.
Action Required
Before January 1, 2026: Billing team must update prior authorization workflows for Daxxify injections for Humana Medicaid Ohio members. Verify patients meet all three criteria: cervical dystonia diagnosis, age 18+, and previous treatment/intolerance/contraindication to Dysport or Xeomin. Update encounter forms to capture required documentation. Claims will be denied without proper prior authorization.