MedicaidPrior AuthMedium impact
Daxxify® (daxibotulinumtoxinA-lanm) (Revised)
Humana·SC · Neurology, Pain Management, PM&R (Physical Medicine & Rehab)·Medicaid
Effective date
Jul 1, 2024
We identified it
Jun 24, 2026
Summary
Humana Medicaid South Carolina has established a new prior authorization policy for Daxxify (daxibotulinumtoxinA-lanm) effective July 1, 2024. The policy requires prior authorization for cervical dystonia treatment in adults 18+ who have failed or cannot tolerate Dysport or Xeomin, and explicitly excludes coverage for cosmetic uses and numerous other conditions.
Action Required
Immediately: Billing team must update prior authorization requirements for Daxxify injections for Humana Medicaid South Carolina members. Verify patients are 18+ with cervical dystonia diagnosis and have documentation of previous treatment failure, intolerance, or contraindication to Dysport or Xeomin before scheduling. Claims for cosmetic uses or excluded conditions will be denied.