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Injections for Chronic Pain Conditions - MEDICAID - OKLAHOMA (Revised)
Effective date
Jul 29, 2026
Identified
Jul 22, 2026
Summary
Humana Oklahoma Medicaid updated its policy for chronic pain injections (epidural steroid injections, facet joint injections, sacroiliac joint injections, trigger point injections, and peripheral nerve blocks) effective July 29, 2026. The policy establishes specific coverage criteria including mandatory 4-week conservative treatment, radicular pain confirmation, imaging guidance requirements, and strict frequency/level limitations for procedures. Billing teams must ensure prior authorization compliance and proper documentation of conservative treatment attempts before claim submission.
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What to do
Action · 6 steps
01Before July 29, 2026: Billing team must update prior authorization workflows in billing system to require documentation of 4 consecutive weeks of conservative treatment (activity modification, medications, physical therapy) before approving codes 62321, 62323, and 64483.
02Implement system checks to enforce: (1) maximum 1 nerve root level per session for caudal/interlaminar approaches, (2) maximum 2 injections per session for transforaminal/SNRB (unilateral or bilateral single level), (3) minimum 2-week intervals during diagnostic phase (max 2 injections), (4) minimum 2-month intervals during therapeutic phase, and (5) requirement that real-time imaging guidance (CT/fluoroscopy) be documented as integral to procedure.
03Providers must confirm radicular pain with positive straight leg raise or dermatomal sensory loss.
04Update encounter templates to require documentation of these criteria.
05Billing team must deny claims lacking required prior authorization and supporting documentation.
06Train billing and provider staff on new frequency limitations and level restrictions to prevent over-coding and claim denials.
Codes mentioned
623216232364483
Original notice
Injections for Chronic Pain Conditions - MEDICAID - OKLAHOMA (Revised)
mcp.humana.com · Always check the source before changing claims.
Related changes
See all Humana changes →Injections for Chronic Pain Conditions - MEDICAID - SOUTH CAROLINA (Revised)HighEffective Jan 1, 2025 · MedicaidInjections for Chronic Pain Conditions - MEDICAID - KENTUCKY (Revised)HighEffective Jul 15, 2026 · MedicaidInjections for Chronic Pain Conditions - MEDICAID - OKLAHOMA (New)HighEffective Jan 7, 2026 · MedicaidInjections for Chronic Pain Conditions - MEDICAID - MICHIGAN (New)HighEffective May 22, 2026 · MedicaidBrowse every Humana change in the policy list