Botulinum Toxin Injections
J15
28 active Medicare policies list J0587, and 35 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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J15
J15 · Effective Feb 22, 2026
J6 · Effective Feb 22, 2026
JK · Effective Feb 22, 2026
JE · Effective Oct 1, 2015
JF · Effective Oct 1, 2015
JJ · Effective Feb 22, 2026
JM · Effective Feb 22, 2026
J5
J5 · Effective Feb 22, 2026
35 policies from 14 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.
Showing 10 of 11 · All Aetna policies
| Policy | Effective | Status of J0587 |
|---|---|---|
| Alopecia Areata | Feb 16, 2024 | Covered |
| Headaches: Invasive Procedures | Feb 20, 2024 | Covered |
| Hyperhidrosis | Jul 18, 2023 | Covered |
| Levator Syndrome Treatments | Sep 19, 2023 | Covered |
| Post-Herpetic Neuralgia | Feb 20, 2024 | Covered |
| Rosacea |
J5
J8 · Effective Feb 22, 2026
J9 · Effective Oct 1, 2015
JH · Effective Mar 21, 2021
JL · Effective Mar 21, 2021
National · Effective Apr 9, 2026
National · Effective Apr 9, 2026
National · Effective Apr 9, 2026
National · Effective Apr 9, 2026
National · Effective Apr 9, 2026
J9 · Effective Nov 9, 2025
JH · Effective Nov 9, 2025
National · Effective Apr 9, 2026
National · Effective Sep 6, 2026
JL · Effective Sep 6, 2026
| Aug 10, 2023 |
| Covered |
| Selective Peripheral Denervation (Bertrand Procedure) | Jun 7, 2023 | Covered |
|---|
| Tinnitus Treatments | Feb 16, 2024 | Covered |
|---|
| Trigeminal Neuralgia: Treatments | Feb 15, 2024 | Covered |
|---|
| Vocal Cord Paralysis / Insufficiency Treatments | May 5, 2023 | Covered |
|---|
Showing 10 of 11 · All EviCore by Evernorth policies
| Policy | Effective | Status of J0587 |
|---|---|---|
| Myobloc (rimabotulinumtoxinB) | Not recorded | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Myobloc (rimabotulinumtoxinB)Effective 08/01/2023 - 07/31/2024 | Aug 1, 2023 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Myobloc (rimabotulinumtoxinB)Effective 08/01/2024 - 07/31/2025 | Aug 1, 2024 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Myobloc (rimabotulinumtoxinB)Effective 08/01/2025 - 07/31/2026 | Aug 1, 2025 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| RimabotulinumtoxinB (Myobloc)Effective 01/01/2019 - 09/30/2020 | Jan 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| RimabotulinumtoxinB (Myobloc)Effective 03/01/2019 - 08/30/2019 | Mar 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| RimabotulinumtoxinB (Myobloc)Effective 06/01/2017 - 02/28/2019 | Jun 1, 2017 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| RimabotulinumtoxinB (Myobloc)Effective 08/01/2022 - 07/31/2023 | Aug 1, 2022 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| RimabotulinumtoxinB (Myobloc)Effective 09/01/2019 - 12/31/2019 | Sep 1, 2019 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| RimabotulinumtoxinB (Myobloc)Effective 09/01/2021 - 07/31/2022 | Sep 1, 2021 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Botulinum toxins: abobotulinumtoxinA (Dysport), incobotulinumtoxinA (Xeomin), onabotulinumtoxinA (Botox), and rimabotulinumtoxinB (Myobloc) – Minnesota Health Care Programs | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Botulinum toxins: abobotulinumtoxinA (Dysport), incobotulinumtoxinA (Xeomin), onabotulinumtoxinA (Botox), rimabotulinumtoxinB (Myobloc), and daxibotulinumtoxinA-lanm (Daxxify) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Botulinum Toxin | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Botulinum Toxin | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Botulinum Toxin | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Botulinum Toxin | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0587 |
|---|---|---|
| RimabotulinumtoxinB (Myobloc) | Jan 13, 2026 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0587 |
|---|---|---|
| RimabotulinumtoxinB (Myobloc); CP.PHAR.233 | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Myobloc (rimabotulinumtoxinB) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Botulinum Toxins A and B | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Botulinum Toxins A and B | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Botulinum Toxins A and B | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J0587 |
|---|---|---|
| Treatment of Temporomandibular Joint (TMJ) | Not recorded | Covered |