Medicare AdvantagePrior AuthMedium impact
Lidocaine 5% topical ointment (Revised)
Humana·Dermatology, Pain Management, General Surgery +2 more·Medicare Advantage
Effective date
Jan 1, 2026
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Lidocaine 5% topical ointment effective January 1, 2026. Members must have tried both lidocaine 2% and lidocaine/prilocaine before the 5% strength will be approved.
Action Required
By January 1, 2026: Billing team must update prior authorization workflows for Lidocaine 5% topical ointment prescriptions for Humana Medicare Advantage patients. Providers must document that patients have trialed both lidocaine 2% AND lidocaine/prilocaine before prescribing 5% strength. Visit www.humana.com/PAL for preauthorization requirements. Claims without proper prior authorization will be denied.