Medicare AdvantagePrior AuthMedium impact
Vyepti® (eptinezumab) (Revised)
Humana·Neurology, Pain Management·Medicare Advantage
We identified it
Jul 23, 2026
Summary
This is a revised Prior Authorization policy for Vyepti® (eptinezumab), a monoclonal antibody for migraine prevention in Medicare Advantage members. The specific changes from the previous version are not detailed in the summary-only source provided, but billing teams must implement the current prior authorization requirements immediately to avoid claim denials.
Action Required
Immediately: Billing team must implement prior authorization requirement for Vyepti® (eptinezumab) injections for all Medicare Advantage patients. Update billing system to flag claims requiring prior auth before submission. Providers should verify patient eligibility and obtain Humana prior authorization before administering Vyepti®. Reference the revised policy at https://dctm.humana.com/Mentor/Web/v.aspx?objectID=090009298a5867b8 for specific authorization criteria. Without prior authorization, claims will be denied and reimbursement delayed.