CPT J0585 · HCPCS Drug · Sunshine Health (Centene) — Florida Medicaid

Botox — OnabotulinumtoxinA drug (HCPCS) at Sunshine Health (Centene) — Florida Medicaid.

How Sunshine Health (Centene) — Florida Medicaid 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.

Free with practitioner sign-in — magic-link email auth, no credit card.

Coverage Covered

Prior auth Prior auth required

Last reviewed 2026-05-06

Policy numberFL Medicaid PDL / Magellan pharmacy PA

Criteria summary

High-level themes from the Sunshine Health (Centene) — Florida Medicaid 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: Sunshine Health FL Medicaid — J0585 (OnabotulinumtoxinA) billed via FL Medicaid pharmacy benefit (PDL, administered by Magellan Medicaid Administration)

See the full Sunshine Health (Centene) — Florida Medicaid 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.

Botox — OnabotulinumtoxinA drug (HCPCS) at Sunshine Health (Centene) — Florida Medicaid.

Criteria summary

See the full Sunshine Health (Centene) — Florida Medicaid criteria.

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