Botulinum Toxin

Covers botulinum toxin therapy for FDA‑approved and evidence‑supported indications across neurologic, urologic, gastrointestinal, ocular and movement‑disorder conditions (e.g., spasticity, chronic migraine, cervical dystonia, blepharospasm, strabismus, neurogenic detrusor overactivity, overactive bladder, achalasia, chronic anal fissure). Coverage is limited to uses, doses and frequencies consistent with FDA labeling or nationally recognized references (e.g., MCG, DrugDex, NCCN); off‑label use requires at least two supporting peer‑reviewed articles, and final coverage is subject to member benefit plan, contract and applicable state requirements.

"Use of botulinum toxin for diagnoses or procedures where the therapy is proven effective for the relevant diagnosis."

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