Medicare AdvantagePrior AuthMedium impact
Tyrvaya® (varenicline) (Revised)
Humana·Medicare Advantage
We identified it
Jul 2, 2026
Summary
Unable to provide complete analysis. This policy references Tyrvaya® (varenicline) for Medicare Advantage members with a prior authorization requirement, but only summary-level information is available from the source. The full policy content is not accessible through the provided URL (content source indicates 'Summary Only'). Billing team must access the complete policy document to identify specific prior auth triggers, covered diagnoses, and documentation requirements.
Action Required
By end of business today: Billing team must access the complete Tyrvaya® (varenicline) prior authorization policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a56a5b2 or contact Humana directly to obtain full policy details including: (1) specific HCPCS/CPT codes requiring prior auth, (2) covered indications and diagnoses, (3) prior auth submission requirements and timeframes, (4) effective date. Do NOT bill Tyrvaya® claims for Medicare Advantage members without first documenting the complete prior auth requirements. Update billing software and provider communication templates once full policy details are obtained. Failure to comply will result in claim denials.