Daxxify® (daxibotulinumtoxinA-lanm)

Daxxify (daxibotulinumtoxinA‑lanm) is covered only for the FDA‑approved indication of cervical dystonia in adults (≥18) and is excluded for all other uses. Approval is for 12 months with recommended dosing 125–250 Units IM per treatment divided among affected muscles, administered no more frequently than every three months, and requires documentation of diagnosis, patient age, dose/muscles/date of administration and adherence to the policy’s specific safety/coverage criteria.

"FDA‑approved indication: Treatment of cervical dystonia in adult patients."

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