Botulinum Toxin

Aetna covers onabotulinumtoxinA (Botox), abobotulinumtoxinA (Dysport) and incobotulinumtoxinA (Xeomin) for specified neuromuscular and hypersecretory indications—eg, cervical dystonia (adults), chronic sialorrhea, primary axillary/palmar/gustatory hyperhidrosis (Botox/Dysport only), upper‑limb spasticity, achalasia (after failure/unsuitability of dilation or myotomy), chronic anal fissures (after failure of topical therapy), and blepharospasm (age ≥12); rimabotulinumtoxinB (Myobloc) and daxibotulinumtoxinA (Daxxify) are covered only if contraindication, intolerance, or inadequate response to the equivalent alternatives. Precertification is required for all botulinum products, cosmetic uses are excluded, and other unlisted uses—as well as testing for neutralizing antibodies and electrical‑stimulation augmentation—are considered experimental/investigational.

"OnabotulinumtoxinA (Botox) medically necessary indications (initial approval): Achalasia — Treatment of achalasia when the member has tried and failed or is a poor candidate for conventional therap..."