CPT J0585 · HCPCS Drug · Health Partners Plans / Jefferson Health Plans — PA HealthChoices
Botox — OnabotulinumtoxinA drug (HCPCS) at Health Partners Plans / Jefferson Health Plans — PA HealthChoices.
How Health Partners Plans / Jefferson Health Plans — 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 Health Partners Plans / Jefferson Health Plans — PA HealthChoices policy of record for CPT J0585. Verbatim policy text and per-criterion analysis are available after sign-in.
- At least 12 weeks of conservative care typically required.
Source: HPP/Jefferson Health Plans — medical drug PA pathway; PA Medical Assistance Statewide PDL
See the full Health Partners Plans / Jefferson Health Plans — PA HealthChoices criteria.
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