CPT J0585 · HCPCS Drug · AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoices
Botox — OnabotulinumtoxinA drug (HCPCS) at AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoices.
How AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoices approaches CPT J0585 (Botox — OnabotulinumtoxinA drug (HCPCS)) 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 AmeriHealth Caritas Family (ACPA / AC Northeast / Keystone First) — PA HealthChoices policy of record for CPT J0585. Verbatim policy text and per-criterion analysis are available after sign-in.
Coverage criteria details available after sign-in.
Source: AC Family Medical Drug PA / PA Medicaid PDL — Physician-Administered Drug
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