Rubrica

CPT 64646 · Botulinum Toxin · Geisinger Health Plan — PA HealthChoices

Botox — Trunk/Axial Chemodenervation (1–5 muscles) at Geisinger Health Plan — PA HealthChoices.

How Geisinger Health Plan — PA HealthChoices approaches CPT 64646 (Botox — Trunk/Axial Chemodenervation (1–5 muscles)) for prior-authorization review: at last review on 2026-05-06, the policy covers this code without prior authorization.

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Coverage Covered
Prior auth No prior auth
Last reviewed 2026-05-06

Criteria summary

High-level themes from the Geisinger Health Plan — PA HealthChoices policy of record for CPT 64646. Verbatim policy text and per-criterion analysis are available after sign-in.

Coverage criteria details available after sign-in.

Source: Geisinger Health Plan PA List (Procedure CPT not enumerated); GHP Family Medical Drug PA list governs J0585

See the full Geisinger Health Plan — PA HealthChoices criteria.

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