MedicaidCoverageHigh impact
Injections for Chronic Pain Conditions - MEDICAID - KENTUCKY (New)
Humana·KY · Pain Management, Anesthesiology, Orthopedics +2 more·Medicaid
Effective date
Mar 26, 2025
We identified it
Jun 24, 2026
Summary
New Kentucky Medicaid policy establishes coverage criteria for chronic pain injection procedures including epidural steroid injections, facet joint injections, nerve blocks, and trigger point injections. The policy requires 4 weeks of conservative treatment failure before injections are covered and becomes effective March 26, 2025.
Action Required
By March 26, 2025: Billing team must update prior authorization requirements for Kentucky Medicaid chronic pain injection claims. Verify all patients have completed 4 consecutive weeks of conservative treatment (activity modification, medications, and physical therapy) before submitting injection claims. Update encounter forms to capture required documentation elements. Claims without proper conservative treatment documentation will be denied.