IncobotulinumtoxinA (Xeomin®)

IncobotulinumtoxinA (Xeomin) is covered only for FDA‑approved indications — cervical dystonia and blepharospasm in adults, and chronic sialorrhea and upper‑limb spasticity in patients ≥2 years — with off‑label uses excluded. Approvals are time‑limited to 12 months and require documentation of age and diagnosis and adherence to specified dosing limits (including pediatric weight‑based dosing) and minimum dosing intervals (generally every 12 weeks; every 16 weeks for sialorrhea).

"When requesting Xeomin (incobotulinumtoxinA), the individual requiring treatment must be diagnosed with one of the following FDA-approved indications and meet the specific coverage guidelines for t..."

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