CMM-205: Chemodenervation-Botulinum Toxin

Botulinum toxin‑A chemodenervation is medically necessary for spasticity and specified movement‑disorder indications (e.g., cervical/focal dystonia, blepharospasm, hemifacial spasm, strabismus, motor tics, vesicourethral spasm, headache, essential tremor) but is not medically necessary for myofascial trigger/tender points, neck or low back pain, cosmetic uses, or other unlisted indications. Repeat injections require documented clinically meaningful benefit lasting ≥8 weeks, are typically given every 3 months with >4 injections per region per year or more frequent dosing often not covered, type‑B toxin is limited to patients refractory to type‑A, and candidates should have a limited number of muscles to treat and no fixed contracture; determinations are case‑by‑case.

"Determination of medical necessity for the use of chemodenervation (i."

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