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Academy Comments on Botulinum Toxin Coverage Proposal

Nov 19, 2024


On November 18, your Academy submitted comments to First Coast Service Options and Novitas regarding their draft local coverage determinations (LCDs) and billing and coding articles on botulinum toxin injection. First Coast and Novitas released their draft LCDs in October, recommending to significantly restrict the list of diagnoses they will pay for. AAPM&R strongly disagrees with the proposed changes and has urged First Coast and Novitas to retain their current coverage of botulinum toxin for spasticity. 

First Coast and Novitas are accepting comments on this issue through November 23.  We strongly encourage members in these jurisdictions to contact your MAC using the LCD links below. 

First Coast
Botulinum Toxin Draft LCD
Draft Coding and Billing Article

Novitas
Botulinum Toxin Draft LCD
Draft Coding and Billing Article

Members with questions about this issue can contact healthpolicy@aapmr.org