Botulinum Toxins

Botulinum toxin injections are covered for focal skeletal muscle spasticity/dystonia (including blepharospasm/hemifacial spasm), selected glandular and smooth-muscle-related conditions (sialorrhea, severe primary axillary hyperhidrosis), neurogenic detrusor overactivity, achalasia, chronic anal fissure, and chronic daily headache/chronic migraine when specified clinical criteria and prior therapy requirements are met. Payment is limited to one injection per defined site; cosmetic uses (e.g., wrinkles) and spastic smooth-muscle conditions are excluded, and failure of two consecutive sessions with a serotype may preclude further coverage of that serotype for one year.

"Botulinum toxin is indicated to reduce spasticity or excessive skeletal muscle contractions (including dystonia, spasticity, hemifacial spasm) to relieve pain, improve posture/walking, increase ran..."