MedicaidPrior AuthMedium impact
iDose® TR (travoprost) intracameral implant (Revised)
Humana·IN · Ophthalmology·Medicaid
Effective date
Jan 1, 2026
We identified it
Jun 25, 2026
Summary
Humana Indiana Medicaid has established a new prior authorization policy for iDose® TR (travoprost) intracameral implant, effective January 1, 2026, with a revision date of June 1, 2026. The policy covers this device for open-angle glaucoma or ocular hypertension treatment but excludes patients with corneal endothelial cell dystrophy or prior corneal transplantation. Billing teams must implement prior authorization requirements before claims are submitted for this intracameral implant procedure.
Action Required
By December 15, 2025: Billing and clinical teams must implement prior authorization workflow for iDose® TR (travoprost) intracameral implant procedures. Specifically: (1) Update billing system to flag all iDose® TR implant requests requiring prior authorization through Humana Indiana Medicaid; (2) Create pre-authorization checklist requiring documentation of open-angle glaucoma or ocular hypertension diagnosis; (3) Train front desk and billing staff to screen for exclusion criteria (corneal endothelial cell dystrophy and prior corneal transplantation history) before submitting authorization requests; (4) Ensure providers document medical necessity and obtain prior authorization BEFORE performing the procedure; (5) Reference www.humana.com/PAL for applicable procedural and medical coding information when submitting requests. Failure to obtain prior authorization will result in claim denials and potential patient liability.