Chemical Peels

This policy covers chemical peel procedures (superficial, medium‑depth, and deep) for medical indications such as numerous or multiple actinic keratoses/premalignant lesions and active or severe acne after failure of topical and/or oral antibiotic therapy, with peel depth selected by agent concentration, duration, and number of applications. Coverage is determined by the member’s benefit plan/contract, cosmetic indications (e.g., photoaging, wrinkles, acne scarring) are excluded, and treatments typically require multiple sessions and adherence to safety/usage limits (e.g., avoidance of high‑risk agents, prescribed wait intervals, and restrictions on repeat medium‑depth peels).

"Dermal chemical peels for individuals with numerous (>10) actinic keratoses or other premalignant skin lesions when treatment of individual lesions is impractical."

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