Medicare AdvantagePrior AuthMedium impact
Gimoti (metoclopramide) (Revised)
Humana·Gastroenterology, Internal Medicine, General Practice·Medicare Advantage
We identified it
Jul 22, 2026
Summary
Humana has revised its Prior Authorization policy for Gimoti (metoclopramide) for Medicare Advantage members. This is a fresh policy update (1 day old) requiring immediate review to ensure billing compliance and proper authorization procedures are in place before claims submission.
Action Required
Immediately: Billing team must access the complete Gimoti (metoclopramide) Prior Authorization policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a5867f0 to identify specific HCPCS codes, coverage criteria, and authorization requirements. Update prior authorization protocols in billing software and provider encounter forms for all Medicare Advantage claims involving Gimoti. Ensure all staff submitting Gimoti claims obtain prior authorization before billing to avoid claim denials. Contact Humana directly if policy details are unclear, as only a summary was available for this analysis.