Medicare AdvantagePrior AuthMedium impact
Daxxify® (daxibotulinumtoxinA-lanm) (Revised)
Humana·KY · Neurology, PM&R (Physical Medicine & Rehab), Pain Management·Medicaid
Effective date
Jan 1, 2024
We identified it
Jun 24, 2026
Summary
Humana has implemented a new prior authorization policy for Daxxify (daxibotulinumtoxinA-lanm) for cervical dystonia treatment in Medicare and Kentucky Medicaid patients. The policy requires patients to be 18+ years old with cervical dystonia diagnosis, and Medicaid patients must have failed or cannot use Dysport or Xeomin first.
Action Required
Immediately: Billing team must obtain prior authorization from Humana before administering Daxxify for cervical dystonia in Medicare and Kentucky Medicaid patients. Verify patient meets criteria: 18+ years old, cervical dystonia diagnosis, and for Medicaid patients confirm previous treatment failure/intolerance to Dysport or Xeomin. Visit www.humana.com/PAL for specific medical coding requirements. Claims will be denied without proper prior authorization.