Rubrica

CPT 64615 · Botulinum Toxin

Botox — Chronic Migraine Chemodenervation

Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (e.g., chronic migraine).

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76
Payors tracked
75
Cover this CPT (99%)
49
Require prior auth (64%)
0
Flag investigational

Rubrica tracks payor coverage for CPT 64615 (Botox — Chronic Migraine Chemodenervation) across 76 payors — every Medicare MAC, the major commercial plans, the BCBS family, all 50-state Medicaid programs, and selected workers' comp and auto/PIP carriers. Aggregate coverage patterns are shown below; full payor-specific criteria, source citations, and last-reviewed dates are available to signed-in practitioners.

Top payors covering CPT 64615

Sample of 12 payors with coverage for this code. Sign in for the complete payor list, verbatim criteria, denial-risk score, and source citations for each.

PayorCoveragePrior auth
AetnaCoveredPrior auth
Aetna Better Health of FloridaCoveredPrior auth
Aetna Better Health of MarylandCoveredPrior auth
Aetna Better Health of New JerseyCoveredPrior auth
Aetna Medicare AdvantageCoveredPrior auth
Alabama MedicaidCoveredPrior auth
Alabama Medicaid (FFS)CoveredPrior auth
Allstate Auto / PIPCoveredPrior auth
AmTrust Financial WCCoveredPrior auth
AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoicesCoveredPrior auth
Anthem BCBSCoveredPrior auth
California Medicaid (Medi-Cal)CoveredPrior auth

Coverage themes for CPT 64615

Common patterns across the 76 payors we track. Specific criteria per payor are available after sign-in.

Most payors require ≥8 weeks of conservative care before approving 64615.

2 of 76 payors require imaging concordance documentation.

Of the 76 payors with coverage records for CPT 64615, 49 require prior authorization, 26 cover without prior authorization, and 0 flag the procedure as investigational or experimental under current criteria.

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