Medicare AdvantagePrior AuthMedium impact
Santyl (collagenase) (Revised)
Humana·Wound Care, Dermatology, General Surgery +3 more·Medicare Advantage
Effective date
Jan 1, 2025
We identified it
Jun 24, 2026
Summary
Humana Medicare Advantage now requires prior authorization for Santyl (collagenase) topical ointment effective January 1, 2025. Members must have chronic dermal ulcers or severely burned areas and be using it specifically for wound debridement to qualify for coverage.
Action Required
By January 1, 2025: Billing team and providers must obtain prior authorization from Humana before prescribing or billing for Santyl (collagenase) topical ointment for Medicare Advantage patients. Document that patient has chronic dermal ulcer (pressure, venous, or diabetic ulcer) or severely burned areas and confirm use is for wound debridement. Visit www.humana.com/PAL for specific medical and procedural coding requirements. Claims will be denied without proper prior authorization.