Medicare AdvantagePrior AuthMedium impact
Methocarbamol Containing Products (Revised)
Humana·PM&R (Physical Medicine & Rehab), Sports Medicine, Orthopedics +4 more·Medicare Advantage
Effective date
Apr 2, 2026
We identified it
Jun 25, 2026
Summary
Humana Medicare Advantage has revised its prior authorization policy for methocarbamol-containing products (methocarbamol tablets, Tanlor, Atmeksi) effective April 2, 2026. The policy requires prior authorization for these muscle relaxants and mandates that members must have had a trial with, intolerance, or contraindication to both methocarbamol 500mg AND 750mg tablets before approval for higher-strength formulations. Billing teams must implement prior authorization requirements in their systems and ensure providers document trial history before prescribing.
Action Required
By April 2, 2026: Billing and authorization teams must configure systems to require prior authorization for all methocarbamol-containing products (methocarbamol 500mg tablets, methocarbamol 750mg tablets, methocarbamol 1000mg tablets, Tanlor, and Atmeksi). Update authorization workflows to verify that members meet both approval criteria: (1) using product as adjunct to rest/physical therapy for acute musculoskeletal pain, and (2) have had trial with, intolerance, or contraindication to BOTH 500mg AND 750mg methocarbamol tablets. Communicate requirements to all providers prescribing these medications. Update claim submission templates to prompt for trial history documentation. Do NOT process claims for these medications without prior authorization or claims will be denied. Front desk and authorization staff should reference the Humana PAL (Preauthorization and Notification List) at www.humana.com/PAL for specific medical billing codes.