MedicaidPrior AuthMedium impact
Botox® (onabotulinumtoxinA) (Revised)
Humana·IN · Neurology, Dermatology, Plastic Surgery +3 more·Medicaid
Effective date
Jul 1, 2024
We identified it
Jun 24, 2026
Summary
Humana Indiana Medicaid has revised their Botox prior authorization policy, expanding covered indications to include conditions like chronic anal fissures, chronic migraine prophylaxis, and neurogenic detrusor overactivity, while maintaining strict exclusions for cosmetic uses and experimental indications.
Action Required
Immediately: Review current Botox patients on Indiana Medicaid to ensure they meet the updated prior authorization criteria. Update prior authorization requests to include the new covered indications such as chronic migraine prophylaxis, chronic anal fissures, and neurogenic detrusor overactivity. Ensure documentation excludes cosmetic purposes and experimental uses. Verify age requirements for specific conditions (e.g., 12+ for blepharospasm, 16+ for cervical dystonia, 5+ for NDO).