Medicare AdvantagePrior AuthLow impact
Papzimeos™ (zopapogene imadenovec-drba) (New)
Humana·FL, KY, SC, VA · ENT (Ear, Nose & Throat), Pulmonology·Medicaid
Effective date
Oct 22, 2025
We identified it
Jun 24, 2026
Summary
Humana has introduced a new prior authorization policy for Papzimeos (zopapogene imadenovec-drba), a gene therapy for adults with recurrent respiratory papillomatosis. The therapy requires biopsy confirmation, surgical debulking, and is limited to patients 18+ who haven't completed a previous treatment course.
Action Required
By October 22, 2025: Billing team must update prior authorization requirements for Papzimeos (zopapogene imadenovec-drba) in billing system. Providers treating adults with recurrent respiratory papillomatosis must obtain prior auth with biopsy confirmation, surgical debulking documentation, and patient age verification. Visit www.humana.com/PAL for specific medical and procedural codes.