CPT 64647 · Botulinum Toxin · Wellpoint Maryland
Botox — Trunk/Axial Chemodenervation (6+ muscles) at Wellpoint Maryland.
How Wellpoint Maryland approaches CPT 64647 (Botox — Trunk/Axial Chemodenervation (6+ muscles)) for prior-authorization review: at last review on 2026-04-27, the policy covers this code with prior authorization required.
Free with practitioner sign-in — magic-link email auth, no credit card.
CG-DRUG-31 / DRUG.00003Criteria summary
High-level themes from the Wellpoint Maryland 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: Anthem Medical Policy CG-DRUG-31 / DRUG.00003 — Botulinum Toxin
See the full Wellpoint Maryland criteria.
Sign in for verbatim conservative-care language, exact imaging-concordance rules, repeat-procedure thresholds, and the denial-risk score for any specific clinical scenario.
Sign in — free for practitioners →