CPT 64647 · Chemodenervation · New York Medicaid
Botox — Trunk/Axial Chemodenervation (6+ muscles) at New York Medicaid.
How New York 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 New York 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: New York Medicaid eMedNY Coverage Policy
See the full New York Medicaid criteria.
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