Prior Authorization - JE Part A
New Botulinum Toxin Injection LCD - Effective February 22, 2026
Medicare has finalized a new LCD for Botulinum Toxin Injections. Providers are encouraged to review coverage requirements prior to the effective date: Botulinum Toxin Types A and B (L35170)
Prior Authorization
Prior Authorization for Certain Hospital Outpatient Department (OPD) Services - View outpatient department services that require prior authorization, the authorization process, how to submit a prior authorization request, the documentation requirements and coverage for the 8 services: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, vein ablation, spinal cord neurostimulator, cervical fusion and facet joint intervention for pain management.
Resources
OPD Prior Authorization Coding
64612, 64615
Procedure codes must be paired with the botulinum product HCPCS code: J0585, J0586, J0587, J0588
Prior Authorization Lookup Tool
Enter CPT/HCPCS Code:
Prior Authorization UTN Calculator
A Unique Tracking Number (UTN) is valid for 120 calendar days, counting the decision date as day one.
Note: Enter dates as (mm/dd/yyyy)
