OnabotulinumtoxinA (Botox®)

OnabotulinumtoxinA (Botox) is covered for the listed FDA-approved indications (e.g., OAB, detrusor overactivity with neurologic condition, chronic migraine, spasticity, dystonias, hyperhidrosis, blepharospasm, strabismus) and select compendial off‑label uses (e.g., sialorrhea, achalasia, anal fissure) when submitted criteria are met. Coverage requires indication‑specific documentation of prior therapy/failure (e.g., anticholinergic failure and absence of UTI/retention for OAB; ≥2 preventive agents and ≥15 headache days/month for initial chronic migraine approval), adherence to dosing, max‑unit and injection site/frequency limits, and specified authorization durations (initial: 6 months for migraine, 12 months for others; reauthorization: 12 months).

"Overactive bladder"

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