Medicare AdvantagePrior AuthMedium impact
Levorphanol tablets (Revised)
Humana·Pain Management, Oncology, Anesthesiology +1 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires step therapy for levorphanol tablets (including Xyvona), requiring patients to have failed or been contraindicated to TWO of the following immediate-release opioids: oxycodone, hydromorphone, or morphine before coverage is approved.
Action Required
Before January 1, 2026: Billing team and providers must implement step therapy documentation for levorphanol tablet prescriptions. Ensure patient records document previous treatment failure, contraindication, or intolerance to at least TWO of these opioids: oxycodone, hydromorphone, or morphine. Update prior authorization workflows to include this step therapy requirement. Claims may be denied without proper step therapy documentation.