Xeomin (incobotulinumtoxinA)

Xeomin is covered only for the FDA‑approved indications — cervical dystonia and blepharospasm in adults (≥18 years), and chronic sialorrhea and upper‑limb spasticity in patients ≥2 years — with no coverage for off‑label uses. Coverage requires adherence to specified dosing and minimum intervals (blepharospasm 50 U initial, ≤100 U/session, ≥12 weeks; cervical dystonia 120 U, ≥12 weeks; adult upper‑limb spasticity up to 400 U, ≥12 weeks; pediatric upper‑limb spasticity 8 U/kg single limb [max 200 U] or 16 U/kg both limbs [max 400 U], ≥12 weeks; chronic sialorrhea adults 100 U [30 U parotid/20 U submandibular], pediatric sialorrhea weight‑based 3:2 parotid:submandibular, ≥16 weeks), approvals are for 12 months and no additional documentation is specified.

"Cervical dystonia in adults."

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