tci Part B Insider - 2004 Issue 28

Medications: Separate Botulinum Types For Optimum Reimbursement

Practice loses money with Botox, makes $139 with MyoblocThe Food and Drug Administration may have approved Botulinum Type B (Myobloc) for cervical dystonia, but some Part B carriers have led the way in covering it for the same uses as Type A (known as Botox). For example, Trailblazer says flatly that it'll cover Myobloc for the same uses as Botox. Other carriers have imposed much more restrictive criteria, but the trend appears to be heading toward looser restrictions, especially on the East coast, say billing experts.  With two kinds of botulinum available, it's important to keep the...

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