Botulinum Toxins

Medicare covers specific botulinum toxin products (Botox, Dysport, Xeomin, Myobloc, Daxxify) for their FDA‑labeled indications and for a limited set of off‑label uses (notably select uses of Botox and Dysport) when documentation supports the clinical circumstances described in this LCD. Coverage excludes procedures deemed cosmetic (including Jeuveau/prabotulinumtoxinA), certain injection sites or indications (e.g., esophageal body injection, isolated lower‑limb dystonia, abductor spasmodic dysphonia), and requires product‑specific documentation and adherence to CMS medical necessity rules; claims are subject to post‑payment review and audits.

"Botulinum toxin products onabotulinumtoxinA (Botox), abobotulinumtoxinA (Dysport), incobotulinumtoxinA (Xeomin), rimabotulinumtoxinB (Myobloc), and daxibotulinumtoxinA (Daxxify) are covered when ad..."

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