MedicaidPrior AuthMedium impact
Kimmtrak (tebentafusp-tebn) (Revised)
Humana·IN · Oncology·Medicaid
We identified it
Jul 21, 2026
Summary
Humana has issued a revised Prior Authorization policy for Kimmtrak (tebentafusp-tebn), a oncology treatment for Medicaid-Indiana members. The specific details of the revision are not available in this summary-only format, but billing teams must obtain prior authorization before administering this drug to avoid claim denials.
Action Required
Immediately: Billing team must verify current Kimmtrak prior authorization requirements in the full policy document at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a58481e. Update billing system and encounter forms to require prior authorization for CPT J9325 (Kimmtrak) for all Medicaid-Indiana claims. Instruct providers and clinical staff to submit prior authorization requests before treatment initiation. Claims submitted without prior authorization will be denied by Humana Medicaid-Indiana.