Medicare AdvantagePrior AuthMedium impact
Xepi (ozenoxacin) topical cream (Revised)
Humana·Dermatology, Pediatrics, Infectious Disease +1 more·Medicare Advantage
Effective date
Dec 18, 2024
We identified it
Jun 25, 2026
Summary
Humana revised its Xepi (ozenoxacin) topical cream prior authorization policy effective December 18, 2024. The policy maintains prior authorization requirements for impetigo treatment and clarifies that Xepi requires documentation of previous treatment failure, contraindication, or intolerance to mupirocin within the past 12 months, with age requirement of 2+ months. This is a policy revision (not a new policy) affecting Medicare Advantage and Commercial plan members.
Action Required
By December 18, 2024: Billing and prior authorization teams must update internal guidelines to reflect the revised Xepi approval criteria. Ensure that all prior authorization requests for Xepi include: (1) diagnosis of impetigo confirmed, (2) member age verification (2 months or older), and (3) documentation of previous treatment with topical mupirocin within the past 12 months OR documented contraindication/intolerance to mupirocin. Update PA submission templates and clinical review workflows to enforce these three criteria. Notify providers that requests missing documentation of mupirocin failure/contraindication will be denied. Flag any existing standing orders for Xepi and verify member eligibility against revised criteria.