MedicaidPrior AuthMedium impact
Elrexfio (elranatamab-bcmm) (Revised)
Humana·IN · Oncology·Medicaid
We identified it
Jul 21, 2026
Summary
Humana has issued a revised Prior Authorization policy for Elrexfio (elranatamab-bcmm), a specialty pharmaceutical used in oncology treatment for Medicaid-Indiana members. This update supersedes any previous guidance and requires immediate review to determine authorization requirements and billing workflow changes.
Action Required
Immediately: Billing and clinical teams must obtain the complete policy document from the source URL (https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a584824) to extract specific prior authorization requirements, covered indications, documentation requirements, and applicable HCPCS J-codes for Elrexfio. Update authorization protocols in the billing system and clinical workflow. Contact Humana directly if the complete policy is not accessible to confirm effective date and requirements. Do not bill claims for Elrexfio without confirming prior authorization status with this plan. Claims submitted without required authorization will be denied.