CPT 64647 · Botulinum Toxin · Maryland Medicaid
Botox — Trunk/Axial Chemodenervation (6+ muscles) at Maryland Medicaid.
How Maryland Medicaid approaches CPT 64647 (Botox — Trunk/Axial Chemodenervation (6+ muscles)) for prior-authorization review: at last review on 2026-05-06, the policy covers this code with prior authorization required.
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Criteria summary
High-level themes from the Maryland Medicaid policy of record for CPT 64647. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: Maryland Medicaid HealthChoice Program / COMAR 10.09
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