Medicare AdvantagePrior AuthMedium impact
Carbidopa/Levodopa Extended-Release Products (Revised)
Humana·Neurology, Family Medicine, General Practice +1 more·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage has implemented a step therapy policy for extended-release carbidopa/levodopa products (Rytary, Crexont) effective January 1, 2025. Patients must try or be unable to use at least one other carbidopa-levodopa containing product before these extended-release formulations will be covered.
Action Required
Immediately: Billing team must implement prior authorization requirements for Rytary and Crexont prescriptions for Humana Medicare Advantage members. Providers must document that patients have tried or cannot use at least one other carbidopa-levodopa containing product before prescribing these extended-release formulations. Update prescription protocols to include step therapy documentation requirements to avoid coverage denials.