Medicare AdvantagePrior AuthMedium impact
Dysport® (abobotulinumtoxinA) (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 updated their Dysport® (abobotulinumtoxinA) prior authorization policy for Medicare and Medicaid Kentucky plans. The policy establishes specific age and diagnosis criteria for cervical dystonia (18+ years), lower limb spasticity (2+ years), and upper limb spasticity (2+ years), while explicitly excluding coverage for numerous cosmetic and investigational uses.
Action Required
Immediately: Prior authorization staff must verify patient age and diagnosis requirements before submitting Dysport® requests for Humana Medicare/Medicaid Kentucky members. Ensure cervical dystonia patients are 18+ years old and spasticity patients are 2+ years old. Do not submit requests for any of the listed exclusions including cosmetic uses, migraines, chronic pain, or other non-covered indications as these will be denied.