Medicare AdvantagePrior AuthLow impact
Ctexli (chenodiol) (Revised)
Humana·Endocrinology, Neurology, Genetics·Medicare Advantage
Effective date
Apr 23, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Ctexli (chenodiol) tablets used to treat cerebrotendinous xanthomatosis (CTX). Coverage requires genetic testing confirmation, age 18+, and specialist care.
Action Required
By April 23, 2025: Billing team must obtain prior authorization from Humana Medicare Advantage before prescribing or billing for Ctexli (chenodiol) tablets for CTX patients. Ensure patient meets all three criteria: genetic testing confirming CYP27A1 gene variant, age 18+, and specialist consultation. Claims will be denied without prior authorization.